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Use of plastic bags to prevent hypothermia at birth in preterm infants--do they work at lower gestations?
1Liverpool Women's Hospital, Crown Street, Liverpool, United Kingdom.
Insights
Polythene bags effectively reduce hypothermia in preterm infants at birth. While benefits were marginal for the most premature infants, overall incidence decreased significantly, improving infant outcomes.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Critical Care
Background:
- Hypothermia at birth poses significant mortality and morbidity risks for preterm infants.
- Occlusive wrapping, including polythene bags, is a recognized method to prevent hypothermia during neonatal resuscitation.
Purpose of the Study:
- To assess the impact of introducing polythene bags during resuscitation on infant admission temperatures.
- To evaluate the effectiveness of polythene bag use in infants born before 30 weeks gestation.
Main Methods:
- A retrospective audit analyzed admission temperatures of infants born before 30 weeks gestation.
- Data was collected for two years pre- and two years post-introduction of polythene bags.
- Hypothermia was defined as an axillary temperature below 36°C.
Main Results:
- The overall incidence of hypothermia decreased from 25% to 16% after polythene bag implementation (p=0.098).
- A significant reduction in hypothermia was observed in infants born above 28 weeks gestation (19.4% to 3.9%, p=0.017).
- No significant effect was found in infants born between 28 and 30 weeks gestation (29.3% to 24.8%, p=0.58).
Conclusions:
- Polythene bags are effective in lowering admission hypothermia rates for preterm infants under 30 weeks gestation.
- The observed benefit for infants under 28 weeks was marginal, differing from some previous studies.
- Lower baseline hypothermia rates at the center may explain the marginal benefit in the most premature infants.
Background:
Hypothermia at birth is strongly associated with mortality and morbidity in preterm infants. Occlusive wrapping of preterm infants during resuscitation, including polythene bags have been shown to prevent hypothermia.
Objectives:
To evaluate the effectiveness of the introduction of polythene bags at resuscitation of infants born below 30 weeks gestation in a large tertiary neonatal centre.
Methods:
Retrospective audit of admission temperatures of all infants born below 30 weeks gestation for two years before and two years after the introduction of polythene bags. Hypothermia was defined as admission axillary temperature < 36 degrees C.
Results:
A total of 334 eligible infants were born during the study period. Two hundred and fifty-three (75.8%) had admission temperatures recorded. The incidence of hypothermia fell from 25% to 16%(p = 0.098) for the whole group since the introduction of polythene bags. The main reduction in hypothermia was seen in infants born above 28 weeks gestation (19.4% vs. 3.9%, p = 0.017). There was no significant effect in infants born between 28 weeks and 30 weeks (29.3% vs. 24.8%, p = 0.58).
Conclusions:
Polythene bags are effective in reducing the incidence of hypothermia at admission in infants born below 30 weeks gestation. The benefit in infants born below 28 weeks gestation was only marginal. This is in contrast to previously published studies. This may be related to the comparatively low incidence of hypothermia at the study centre even prior to introduction of polythene bags.
