Reducing hypothermia in preterm infants following delivery

Area of Science:

• Neonatal care
• Pediatric medicine
• Thermoregulation

Background:

• Moderate hypothermia (temperature <36°C) is prevalent in premature infants.
• Hypothermia at birth is linked to increased mortality and morbidity in neonates.

Purpose of the Study:

• To assess a multifaceted approach to reduce hypothermia in premature infants (<35 weeks gestation).
• To decrease the incidence of admitting axillary temperature <36°C by 20% without increasing hyperthermia (>37.5°C).

Main Methods:

• Implementation of a multidisciplinary practice plan including occlusive wrap, transwarmer mattress, and cap.
• Maintaining operating room temperature between 21°C and 23°C.
• Data collection at baseline, during phasing in, and at full implementation.

Main Results:

• Infant axillary temperatures in the delivery room and upon admission significantly increased (P < .001).
• Incidence of hypothermia (<36°C) decreased from 55% to 6.2% (P < .001).
• Intubation at 24 hours decreased from 39% to 17.6% (P = .005), with no increase in hyperthermia.

Conclusions:

• The practice plan effectively increased infant temperatures and reduced moderate hypothermia.
• A significant reduction in 24-hour intubation rates was observed.
• Increased compliance with the practice plan correlated with positive outcomes.