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Golden hour of neonatal life: Need of the hour
1National Institute of Medical Science, Jaipur, Rajasthan India.
Insights
The "Golden Hour" in neonatology emphasizes evidence-based interventions during the first hour of life for newborns. This critical period aims to improve long-term outcomes for both preterm and term infants.
Area of Science:
- Neonatology
- Perinatal Medicine
- Pediatric Critical Care
Background:
- The
- Golden Hour
- concept in neonatology mirrors trauma care, focusing on the first hour post-birth for optimal infant outcomes.
- While evidence supports its benefit in preterm infants, its application in term neonates is gaining recognition among neonatologists.
Purpose of the Study:
- To review the components of neonatal care within the
- Golden Hour
- for both preterm and term neonates.
- To highlight the importance of timely, evidence-based interventions during this critical postnatal period.
Main Methods:
- This review synthesizes current evidence and expert opinion on neonatal care practices within the first hour of life.
- It examines interventions including resuscitation, post-resuscitation care, stabilization, and initial nursery management.
Main Results:
- Studies in preterm infants show the
- Golden Hour
- approach significantly reduces hypothermia, hypoglycemia, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP).
- The concept is considered crucial for both preterm and term neonates, despite varying levels of direct evidence.
Conclusions:
- Implementing the
- Golden Hour
- protocol is vital for improving neonatal outcomes.
- Standardizing evidence-based care during the first hour of life is essential for all newborns, irrespective of gestational age.
Abstract:
"Golden Hour" of neonatal life is defined as the first hour of post-natal life in both preterm and term neonates. This concept in neonatology has been adopted from adult trauma where the initial first hour of trauma management is considered as golden hour. The "Golden hour" concept includes practicing all the evidence based intervention for term and preterm neonates, in the initial sixty minutes of postnatal life for better long-term outcome. Although the current evidence supports the concept of golden hour in preterm and still there is no evidence seeking the benefit of golden hour approach in term neonates, but neonatologist around the globe feel the importance of golden hour concept equally in both preterm and term neonates. Initial first hour of neonatal life includes neonatal resuscitation, post-resuscitation care, transportation of sick newborn to neonatal intensive care unit, respiratory and cardiovascular support and initial course in nursery. The studies that evaluated the concept of golden hour in preterm neonates showed marked reduction in hypothermia, hypoglycemia, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP). In this review article, we will discuss various components of neonatal care that are included in "Golden hour" of preterm and term neonatal care.
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