Interventions to prevent hypothermia at birth in preterm and/or low birthweight babies

McCall, Emma; Alderdice, FA; Halliday, Henry L.; Jenkins, JG; Vohra, Sunita

doi:10.1002/14651858.cd004210.pub2

Cited by 49 publications

(25 citation statements)

References 69 publications

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“…A Cochrane review [305] concluded use of plastic wraps or bags, transwarmer mattresses, and early skin-to-skin contact, all kept preterm and/or low birth weight babies warmer compared to routine thermal care. Another Cochrane review compared incubators with radiant heaters in preterm babies [306], showing no differences in severe infections or deaths, although radiant heaters were associated with greater water loss.…”

Section: Resultsmentioning

confidence: 99%

Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions

Barros

Bhutta

Batra

et al. 2010

BMC Pregnancy Childbirth

215

174

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IntroductionInterventions directed toward mothers before and during pregnancy and childbirth may help reduce preterm births and stillbirths. Survival of preterm newborns may also be improved with interventions given during these times or soon after birth. This comprehensive review assesses existing interventions for low- and middle-income countries (LMICs).MethodsApproximately 2,000 intervention studies were systematically evaluated through December 31, 2008. They addressed preterm birth or low birth weight; stillbirth or perinatal mortality; and management of preterm newborns. Out of 82 identified interventions, 49 were relevant to LMICs and had reasonable amounts of evidence, and therefore selected for in-depth reviews. Each was classified and assessed by the quality of available evidence and its potential to treat or prevent preterm birth and stillbirth. Impacts on other maternal, fetal, newborn or child health outcomes were also considered. Assessments were based on an adaptation of the Grades of Recommendation Assessment, Development and Evaluation criteria.ResultsMost interventions require additional research to improve the quality of evidence. Others had little evidence of benefit and should be discontinued. The following are supported by moderate- to high-quality evidence and strongly recommended for LMICs:• Two interventions prevent preterm births—smoking cessation and progesterone• Eight interventions prevent stillbirths—balanced protein energy supplementation, screening and treatment of syphilis, intermittant presumptive treatment for malaria during pregnancy, insecticide-treated mosquito nets, birth preparedness, emergency obstetric care, cesarean section for breech presentation, and elective induction for post-term delivery• Eleven interventions improve survival of preterm newborns—prophylactic steroids in preterm labor, antibiotics for PROM, vitamin K supplementation at delivery, case management of neonatal sepsis and pneumonia, delayed cord clamping, room air (vs. 100% oxygen) for resuscitation, hospital-based kangaroo mother care, early breastfeeding, thermal care, and surfactant therapy and application of continued distending pressure to the lungs for respiratory distress syndromeConclusionThe research paradigm for discovery science and intervention development must be balanced to address prevention as well as improve morbidity and mortality in all settings. This review also reveals significant gaps in current knowledge of interventions spanning the continuum of maternal and fetal outcomes, and the critical need to generate further high-quality evidence for promising interventions.

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Section: Resultsmentioning

confidence: 99%

Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions

Barros

Bhutta

Batra

et al. 2010

BMC Pregnancy Childbirth

215

174

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“…However, studies have shown that despite these measures many preterm babies are cold on arrival in the neonatal unit 11 12. The use in recent years of polyethylene occlusive skin wraps or plastic bags is effective in reducing TEWL30 and, in babies under 28 weeks' gestation, results in higher temperatures on admission 31 32…”

Section: Options For Achieving These Goalsmentioning

confidence: 99%

Goals and options in keeping preterm babies warm

Lyon

Freer

2010

Archives of Disease in Childhood - Fetal and Neonatal Edition

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More than 50 years after Silverman showed the association between temperature control and mortality, recent data again stress the importance of the thermal environment of the preterm infant. The goals of care are straightforward: maintain a normal body temperature, ensure a stable thermal environment and avoid cold stress; but the options to achieve them are many and less certain. There is a problem in defining a 'normal' temperature. A single measurement will tell nothing about whether the baby is using energy for thermal balance. The preterm baby should be monitored with the continuous recording and display of a central and peripheral temperature. This will give an early indication of cold stress before any change is seen in the central temperature. Reducing evaporative heat losses at birth has improved temperatures on admission, although no studies have shown any effect on outcome. No data have shown that the use of incubators is any better than radiant heaters.

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“…Warming is of vital importance as neonates have a low percentage of body fat and are at high risk of hypothermia. All EDs should possess a warming device as hypothermia incurred during postnatal resuscitation is associated with significant morbidity and mortality 7. The availability was particularly limited in EDs catering for adults only: only 57% of adult-only EDs had a source of warmth compared with 100% of children-only EDs.…”

Section: Discussionmentioning

confidence: 99%

Survey of neonatal resuscitation equipment in emergency departments in the UK

Manias

Davies

Vorwerk

et al. 2010

Emergency Medicine Journal

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There is a good level of provision of neonatal resuscitation equipment in UK EDs, although certain areas need to be addressed. There is a particular need for improving the provision of warming and advanced airway equipment. The authors consider that it is not necessary to have a neonatal Resuscitaire in the ED provided other equipment is readily available. The findings of this survey prompt the recommendation that all EDs should review their neonatal resuscitation equipment in accordance with APLS guidance, and ensure that staff have immediate access to this equipment and are comfortable with its use.

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Interventions to prevent hypothermia at birth in preterm and/or low birthweight babies

Cited by 49 publications

References 69 publications

Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions

Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions

Goals and options in keeping preterm babies warm

Survey of neonatal resuscitation equipment in emergency departments in the UK

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