Thermal Care of Very Preterm Infants in the Delivery Room: A National Survey

Background: Hypothermia in newly born very preterm infants is an independent risk factor for death^1. Maintaining normal body temperature in preterm newborn infants is a vital aspect of delivery room (DR) care. Neonatal resuscitation guidelines suggest using a combination of interventions in the delivery room to maintain normal body temperature².

Objective: We aim to describe the thermal care provided to very preterm infants in level 2 and 3 neonatal centres in Ireland.

Methods: We performed a survey of all level 2 and level 3 neonatal units in Ireland in October 2020.

Results: There was a 90% response rate to the survey. Five respondents (56%) were advanced nurse practitioners (ANP) and four (44%) were clinicians. All centres (100%) use a radiant warmer, hat and a plastic bag/wrap in the DR for infants born

The time to cord clamping (CC) varied across centres; Six (67%) aim for CC after 60 seconds, two (22%) aim for 45 seconds and one (11%) responded that time to CC is led by obstetric staff. Thermal care is not routinely initiated before CC in any centre. Six centres (67%) routinely measure the ambient temperature of the DR and three (33%) routinely measure infant temperature in the DR. All centres measure axillary temperature on admission to the NICU; eight (89%) use the Welch Allyn Suretemp and one (11%) uses an electronic digital thermometer.

Conclusion: We report a variation in practice amongst level 2 and 3 neonatal centres. Further research is necessary to determine best practice for thermal care in the delivery room, with particular attention to the provision of thermal care before CC.