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Thermoregulation and golden hour practices in extremely preterm infants: an international survey

Pranav Jani1,2, Umesh Mishra3,4, Julia Buchmayer5

  • 1Department of Neonatology, Westmead Hospital, Westmead, NSW, Australia. pranav.jani@sydney.edu.au.

Pediatric Research
|September 8, 2022
PubMed

Insights

Thermoregulation and golden hour practices for extremely preterm infants vary globally. Consistent practices include plastic wrap use, early humidity, and local protocols, but significant differences exist based on unit region, income, and infant gestational age.

Area of Science:

  • Neonatal Intensive Care
  • Pediatric Medicine
  • Global Health

Background:

  • Thermoregulation and golden hour management are critical for extremely preterm (EP) infants.
  • Practices may differ significantly across Neonatal Intensive Care Units (NICUs) worldwide.
  • Understanding these variations is key to improving evidence-based care.

Purpose of the Study:

  • To describe and compare thermoregulation and golden hour practices for EP infants globally.
  • To analyze variations based on NICU geographic region, country income status, and lowest gestational age (GA) resuscitated.
  • To identify areas for standardization in neonatal care.

Main Methods:

  • An international e-questionnaire survey was distributed to NICU Directors.
  • Data were collected from February 2019 to August 2021.
  • 848 responses were analyzed from diverse geographic and resource settings.

Main Results:

  • Significant variations in thermoregulation and golden hour practices were observed globally.
  • Consistent practices (>75%) included polyethylene plastic wrap use, humidity within 60 minutes, and local protocols.
  • Practices differed notably in NICUs resuscitating infants from 22-23 weeks GA compared to 24-25 weeks GA, including respiratory support and humidity levels.

Conclusions:

  • Evidence-based thermoregulation and golden hour stabilization practices vary by NICU region, income, and infant GA.
  • Reducing practice variation and aligning with international guidelines is essential.
  • Global standardization of care for EP infants is needed for comparable health outcomes.
Abstract

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