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Transferring preterm infants from incubators to open cots at 1600 g: a multicentre randomised controlled trial
1Grantley Stable Neonatal Unit, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Brisbane 4029, Australia. k.new@uq.edu.au
Insights
Transferring preterm infants to open cots at 1600 g is safe. This study found no adverse effects on temperature control or weight gain for infants moved at 1600 g versus 1800 g.
Area of Science:
- Neonatal care
- Pediatric medicine
- Thermoregulation in infants
Background:
- Current practices for preterm infant care often involve incubators.
- Determining optimal weight for transfer to open cots is crucial for infant well-being.
Purpose of the Study:
- To compare weight gain and temperature stability in preterm infants transferred to open cots at 1600 g versus 1800 g.
Main Methods:
- Randomised controlled trial conducted in Australian neonatal units.
- 182 medically stable preterm infants (<1600 g birth weight) were randomized for transfer at 1600 g or 1800 g.
- Primary outcomes included temperature stability and daily weight gain over 14 days post-transfer.
Main Results:
- The 1600 g group showed significantly better weight gain (17.07 g/kg/day vs 13.97 g/kg/day).
- The 1600 g group had more instances of temperatures >37.1°C post-transfer.
- The 1800 g group experienced more temperatures <36.4°C in the initial 72 hours.
Conclusions:
- Medically stable preterm infants can be safely transferred to open cots at 1600 g.
- Transferring at 1600 g does not negatively impact temperature stability or weight gain.
- This finding supports earlier transfer to open cots for eligible preterm infants.
Objectives:
To determine the effects on weight gain and temperature control of transferring preterm infants from incubators to open cots at a weight of 1600 g versus a weight of 1800 g.
Design:
Randomised controlled trial.
Setting:
One tertiary and two regional neonatal units in public hospitals in Queensland, Australia.
Participants:
182 preterm infants born with a birth weight less than 1600 g, who were at least 48 h old; had not required ventilation or continuous positive airways pressure within the last 48 h; were medically stable with no oxygen requirement, or significant apnoea or bradycardia; did not require phototherapy; and were enterally fed with an intake (breast milk/formula) of at least 60 ml/kg/day.
Interventions:
Transfer into an open cot at 1600 or 1800 g.
Main Outcome Measures:
The primary outcomes were temperature stability and average daily weight gain over the first 14 days following transfer to an open cot.
Results:
90 infants in the 1600 g group and 92 infants in the 1800 g group were included in the analysis. Over the first 72 h, more infants in the 1800 g group had temperatures <36.4°C than the 1600 g group (p=0.03). From post-transfer to discharge, the 1600 g group had more temperatures >37.1°C (p=0.02). Average daily weight gain in the 1600 g group was 17.07 (SD±4.5) g/kg/day and in the 1800 g group, 13.97 (SD±4.7) g/kg/day (p=<0.001).
Conclusions:
Medically stable, preterm infants can be transferred to open cots at a birth weight of 1600 g without any significant adverse effects on temperature stability or weight gain.
Trial Registration:
ACTRN12606000518561 (http://www.anzctr.org.au).
