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Plastic bags for prevention of hypothermia in preterm and low birth weight infants
Alicia E Leadford1, Jamie B Warren, Albert Manasyan
1University of Alabama at Birmingham, Birmingham, AL 35249-7335, USA.
Insights
Using a plastic bag at birth significantly improved normothermia in preterm and low birth weight infants. This low-cost intervention effectively reduces hypothermia in resource-limited settings.
Area of Science:
- Neonatal care
- Thermoregulation
- Global health
Background:
- Hypothermia is a major cause of mortality and morbidity in preterm and low birth weight infants, particularly in developing countries.
- While plastic bags have shown promise in very low birth weight infants, their efficacy in larger infants and resource-limited settings is less understood.
Purpose of the Study:
- To evaluate the effectiveness of placing preterm and low birth weight infants in a plastic bag at birth for maintaining normothermia.
- To assess this intervention in a resource-limited setting.
Main Methods:
- A randomized controlled trial was conducted with 104 infants (26-36 weeks gestational age, 1000-2500g birth weight).
- Infants were assigned to either standard thermoregulation or standard care plus a plastic bag at birth.
- The primary outcome was axillary temperature within the normal range (36.5-37.5°C) at 1 hour postpartum.
Main Results:
- Infants in the plastic bag group (59.2%) were significantly more likely to have a normal temperature at 1 hour compared to the standard care group (32.7%).
- The mean temperature at 1 hour was higher in the plastic bag group (36.5°C) versus standard care (36.1°C).
- No cases of hyperthermia were observed in either group.
Conclusions:
- Placing preterm/low birth weight infants in a plastic bag at birth is an effective method to reduce hypothermia.
- This intervention is a low-cost, low-technology solution suitable for resource-limited settings, without causing hyperthermia.
Background And Objectives:
Hypothermia contributes to neonatal mortality and morbidity, especially in preterm and low birth weight infants in developing countries. Plastic bags covering the trunk and extremities of very low birth weight infants reduces hypothermia. This technique has not been studied in larger infants or in many resource-limited settings. The objective was to determine if placing preterm and low birth weight infants inside a plastic bag at birth maintains normothermia.
Methods:
Infants at 26 to 36 weeks' gestational age and/or with a birth weight of 1000 to 2500 g born at the University Teaching Hospital in Lusaka, Zambia, were randomized by using a 1:1 allocation and parallel design to standard thermoregulation (blanket or radiant warmer) care or to standard thermoregulation care plus placement inside a plastic bag at birth. The primary outcome measure was axillary temperature in the World Health Organization-defined normal range (36.5-37.5°C) at 1 hour after birth.
Results:
A total of 104 infants were randomized. At 1 hour after birth, infants randomized to plastic bag (n = 49) were more likely to have a temperature in the normal range as compared with infants in the standard thermoregulation care group (n = 55; 59.2% vs 32.7%; relative risk 1.81; 95% confidence interval 1.16-2.81; P = .007). The temperature at 1 hour after birth in the infants randomized to plastic bag was 36.5 ± 0.5°C compared with 36.1 ± 0.6°C in standard care infants (P < .001). Hyperthermia (>38.0°C) did not occur in any infant.
Conclusions:
Placement of preterm/low birth weight infants inside a plastic bag at birth compared with standard thermoregulation care reduced hypothermia without resulting in hyperthermia, and is a low-cost, low-technology tool for resource-limited settings.
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