Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Improving neonatal unit admission temperatures in preterm babies: exothermic mattresses, polythene bags or a traditional approach?

Abstract

Objective:

To investigate whether exothermic sodium acetate mattresses were associated with an improvement in the thermal care of babies <30 weeks gestation between birth and admission to a neonatal unit.

Study Design:

Analysis of a three case series of babies: the first with traditional thermal care of drying and wrapping in a towel, the second with wrapping in food standard polythene bags and the third with wrapping in polythene bags and nursing on an activated exothermic mattress. The main outcome measure was the temperature on admission to the neonatal unit.

Result:

There were no significant differences between the groups for gestation and birth weight. Hypothermia was less frequent in the ‘bag and mattress’ group compared with the ‘bag only’ and traditional care groups (26 vs 69 vs 84%, respectively) even though the median time to admission was longest in the ‘bag and mattress’ group (23 min). The proportions of babies admitted with temperatures in the target range of 36.5 to 37.5 °C were 46, 27 and 16%, respectively. Multiple regression analysis showed that use of the mattress raised admission temperatures by 1.04 °C. The median temperature of babies in the ‘bag and mattress’ group was higher compared with the other groups (36.9 vs 36.0 vs 35.8 °C), but significantly more were hyperthermic (28 vs 4 and 0.4%, respectively).

Conclusion:

Use of exothermic mattresses for babies <30 weeks gestation was associated with a significantly greater proportion of babies being admitted to the neonatal unit with a temperature in the euthermic range, but there was also an increased risk of hyperthermia.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Costeloe K, Hennessy E, Gibson AT, Marlow N, Wilkinson AR . The EPICure study: outcomes to discharge from hospital for infants born at the threshold of viability. Pediatrics 2000; 106: 659–671.

    Article  CAS  Google Scholar 

  2. Watkinson M . Temperature control of premature infants in delivery room. Clin Perinatol 2006; 33: 43–53.

    Article  Google Scholar 

  3. World Health Organization. Department of Reproductive Health and Research (RHR). Thermal Protection of the Newborn: A Practical Guide. WHO: Geneva http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/MSM_97_2/en/index.html (date of access 6/9/2008).

  4. Malaysian Very Low Birth Weight Study Group. A national study of risk factors associated with mortality in very low birth weight infants in the Malaysian neonatal intensive care units. J Paediatr Child Health 1997; 33: 18–25.

    Article  Google Scholar 

  5. Daga AS, Daga SR, Patole SK . Determinants of death among admissions to intensive care unit for newborns. J Trop Pediatr 1991; 37: 53–56.

    Article  CAS  Google Scholar 

  6. da Mota Silveira SM, Goncalves de Mello MJ, de Arruda Vidal S, de Frias PG, Cattaneo A . Hypothermia on admission: a risk factor for death in newborns referred to the Pernambuco Institute of Mother and Child Health. J Trop Pediatr 2003; 49: 115–120.

    Article  Google Scholar 

  7. Laptook AR, Salhab W, Bhaskar B . Admission temperature of low birth weight infants: predictors and associated morbidities. Pediatrics 2007; 119: e643–e649.

    Article  Google Scholar 

  8. Knobel RB, Vohra S, Lehman CU . Heat loss prevention in the delivery room for preterm infants: a national survey of newborn intensive care unit. J Perinatol 2005; 25: 514–518.

    Article  Google Scholar 

  9. Vohra S, Frent G, Campbell V, Abbott M, Whyte R . Effect of polythene occlusive skin wrapping on heat loss in very low birth weight infants at delivery: a randomized trial. J Pediatr 1999; 134: 547–551.

    Article  CAS  Google Scholar 

  10. Vohra S, Roberts SR, Zhang B, Janes M, Schmidt B . Heat loss prevention (HELP) in the delivery room. A randomized controlled trial of polyethylene occlusive skin wrapping in very preterm infants. J Pediatr 2004; 145: 750–753.

    Article  Google Scholar 

  11. Lyon AJ, Stenson B . Cold comfort for babies. Arch Dis Child Fetal Neonatal Ed 2004; 89: F93–F94.

    Article  CAS  Google Scholar 

  12. Knobel RB, Wimmer JE, Holbert D . Heat loss prevention for preterm infants in the delivery room. J Perinatol 2005; 25: 304–308.

    Article  Google Scholar 

  13. Lenclen R, Mazraani M, Jugie M, Coudrec S, Hoenn E, Carbajal R et al. Utilisation d’un sac en polythéthylène: un moyen d’améliorer l’environnment thermique du prématuré en salle de naissance. Arch Pédiatr 2002; 9: 238–244.

    Article  CAS  Google Scholar 

  14. Narendran V, Hoath S . Thermal management of the low birth weight infant: a cornerstone of neonatology. J Pediatr 1999; 134: 529–531.

    Article  CAS  Google Scholar 

  15. Brennan AB . Effect of Sodium Acetate Mattress on Admission Temperatures of Infants &lt;1500 g (Master's thesis). University of Florida: Gainesville (FL), 1996.

    Google Scholar 

  16. Guthrie EA . Preventing newborn hypothermia: effectiveness of a warming mattress for transportation of C-section deliveries. Neonatal Int Care 1996; 24: 52–54.

    Google Scholar 

  17. Boo NY, Selvarani S . Effectiveness of a simple heated water-filled mattress for the prevention and treatment of neonatal hypothermia in the labour room. Singapore Med J 2005; 46: 387–391.

    CAS  PubMed  Google Scholar 

  18. Sarman I, Can G, Tunell R . Rewarming preterm infant on a heated water filled mattress. Arch Dis Child 1989; 64: 687–692.

    Article  CAS  Google Scholar 

  19. Nielson HC, Jung AL, Atherton SO . Evaluation of the porta-warm mattress as a source of heat loss for neonatal transport. Pediatrics 1976; 58: 500–504.

    Google Scholar 

  20. L’Herault JL, Petroff L, Jeffrey J . The effectiveness of a thermal mattress in stabilizing and maintaining body temperature during the transport of very low-birth weight newborns. Appl Nurs Res 2001; 14: 210–219.

    Article  Google Scholar 

  21. Carmichael A, McCullough S, Kempley ST . Critical dependence of acetate thermal mattress on gel activation temperature. Arch Dis Child Fetal Neonatal Ed 2007; 92: F44–F45.

    Article  CAS  Google Scholar 

  22. Laptook AR, Watkinson M . Temperature management in the Delivery Room. Semin Fetal Neonatal Med 2009; 13: 383–391.

    Article  Google Scholar 

  23. Newton T, Watkinson M . Preventing hypothermia at birth in preterm babies: at a cost of overheating some? Arch Dis Child Fetal Neonatal Ed 2003; 88: F256.

    Article  CAS  Google Scholar 

  24. Nielsen HC, Jung AL, Atherton SO . Evaluation of the Porta-Warm Mattress as a Source of Heat for Neonatal Transport. Pediatr 1976; 58: 500–504.

    CAS  Google Scholar 

  25. Gunn AJ, Bennet L . Is temperature important in delivery room resuscitation? Semin Neonatol 2001; 6: 241–249.

    Article  CAS  Google Scholar 

  26. Gunn AJ, Gluckman PD . Should we try to prevent hyperthermia after cardiac arrest? Pediatr 2000; 106: 132–133.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M Watkinson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singh, A., Duckett, J., Newton, T. et al. Improving neonatal unit admission temperatures in preterm babies: exothermic mattresses, polythene bags or a traditional approach?. J Perinatol 30, 45–49 (2010). https://doi.org/10.1038/jp.2009.94

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2009.94

Keywords

This article is cited by

Search

Quick links