Acute cardiac care & resuscitation
Maintaining normothermia immediately after birth in preterm infants <34 weeks’ gestation: A systematic review and meta-analysis
Authors' conclusion
DR temperature of ≥23 °C, radiant warmer in manual mode, use of a PBW and a head covering is suggested for preterm newborn infants <34 weeks' gestation.
Study context
- Population
- Preterm newborn infants <34 weeks' gestation
- Comparison
- Delivery room interventions to prevent hypothermia vs standard care or alternatives
Methodological detailsrandom effects meta-analysis, GRADE certainty of evidence, Medline, Embase, CINAHL and CENTRAL searched till 22nd July 2022
- Random effects meta-analysis
- GRADE certainty of evidence
- Medline, Embase, CINAHL and CENTRAL searched till 22nd July 2022
Pooled result
As reported in the abstract
Temperature outcomes by DR intervention
- Delivery room (DR) temperature ≥23 °C vs standard care improved temperature outcomes without increased hyperthermia risk (low certainty)
- Radiant warmer in servo mode vs manual mode decreased mean body temperature (moderate certainty)
- Plastic bag or wrap (PBW) improved normothermia (low certainty)
- Plastic cap improved normothermia (moderate certainty); combined with PBW improved mean body temperature (low certainty)
- Cloth cap decreased moderate hypothermia (low certainty)
- Thermal mattress improved mean body temperature (low certainty)
- Heated-humidified gases for resuscitation decreased moderate hypothermia (very low to low certainty)
Further pooled results
Severe intraventricular hemorrhage
- Heated-humidified gases decreased risk of severe intraventricular hemorrhage (very low to low certainty)
Survival
- No intervention shown to improve survival; sample sizes insufficient
Original publication
Maintaining normothermia immediately after birth in preterm infants <34 weeks’ gestation: A systematic review and meta-analysis. Resuscitation. Published 18 August 2023. doi:10.
Summarised from the published abstract; every number is checked against it