Early Skin-to-Skin Care with a Polyethylene Bag for Neonatal Hypothermia: A Randomized Clinical Trial
Autor: | Catherine Brown, Manimaran Ramani, Amelia Schuyler, Musaku Mwenechanya, Namasivayam Ambalavanan, Waldemar A. Carlo, Claire B. Davis, Elwyn Chomba, Madeline Dills, Albert Manasyan, Colm P. Travers, Inmaculada Aban, Samuel J. Gentle |
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Rok vydání: | 2021 |
Předmět: |
Male
Pediatrics medicine.medical_specialty Skin to skin Hypothermia law.invention 03 medical and health sciences 0302 clinical medicine Neonatal hypothermia Protective Clothing Randomized controlled trial law 030225 pediatrics medicine Humans 030212 general & internal medicine Trial registration Skin care integumentary system business.industry Infant Newborn Combined Modality Therapy Kangaroo-Mother Care Kangaroo-Mother Care Method Treatment Outcome Polyethylene Pediatrics Perinatology and Child Health Referral center Female medicine.symptom business |
Zdroj: | The Journal of Pediatrics. 231:55-60.e1 |
ISSN: | 0022-3476 |
Popis: | To determine whether early polyethylene bag use with skin-to-skin care compared with skin-to skin care alone reduce hypothermia among infants born at term in resource-limited settings.Infants born at term in the tertiary referral center in Lusaka, Zambia, were randomized using sequentially numbered sealed opaque envelopes in 2 phases: after birth (phase 1) and at 1 hour after birth (phase 2) to either skin-to-skin care with polyethylene bags or skin-to-skin care alone. Infant and maternal temperatures were recorded at birth, 1 hour, and every 4 hours until discharge or 24 hours.We enrolled 423 infants from May 2017 to August 2017. The rate of moderate-severe hypothermia (temperature36.0°C) at 1 hour was 72 of 208 (34.6%) in the skin-to-skin care with a polyethylene bag group compared with 101 of 213 (47.4%) in the skin-to-skin care alone group (relative risk, 0.71; 95% CI 0.56-0.90; P .01; number needed to treat = 8). phase 1 treatment assignment significantly modified the effect of phase 2 treatment (P = .02 for interaction effect). Among infants randomized to skin-to-skin care with a polyethylene bag in phase 1, the risk of moderate-severe hypothermia was decreased in infants randomized to continue this intervention until discharge compared with infants randomized to skin-to-skin care alone. The rates of severe hypothermia, hyperthermia, and other adverse events did not differ significantly between groups.Low-cost polyethylene bags started after birth in combination with skin-to-skin care reduced moderate or severe hypothermia at 1 hour and at discharge among infants born at term in a resource-limited setting compared with skin-to-skin care alone.ClinicalTrials.gov: NCT03141723. |
Databáze: | OpenAIRE |
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