Video Analysis of Thermal Care for Very Preterm Infants in the Delivery Room

Emma Dunne ^1,2 Noemi Pellegrino ^1,3 Madeleine Murphy ^1,2 Louise Dowling ² Katherine McDonald ² Colm O'Donnell ^1,2 Lisa McCarthy ^1,2

¹Department of Neonatology, National Maternity Hospital, Dublin, Ireland
²School of Medicine, University College Dublin, Dublin, Ireland
³Department of Medicine and Aging Science, University Gabriele d’Annunzio of Chieti Pescara, Chieti, Italy

Objective: Hypothermia is an independent risk factor for mortality in preterm infants. Neonatal resuscitation guidelines now recommend waiting for at least 1 minute after birth before cord clamping (CC) in uncompromisedpreterm infants. We aimed to observe and document the timing of warming interventions in the era of “delayed cord clamping”.

Study design: We observed video room recordings of infants born

Results: 108 videos were suitable for analysis (median [IQR] gestational age 27 [26-29] weeks and birthweight 1007 [780-1303] grams). Seventeen (15%) infants underwent CC

Conclusion: Initial steps to preserve heat in newly born very preterm infants now takes more time to perform than guidelines recommend. Neonatal resuscitation guidelines should consider that an increased time to CC impacts the time to initiation of thermal care.

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