The Effect of Plastic Wrap Use to Prevent Hypothermia on Neonatal Mortality and Morbidity in Extreme Preterm Infants

Abstract

Hypothermia immediately afterbirth is common, especially in preterm (PT) infants because of their skin immaturity. If it is prolonged, it can lead to mortality and morbidity. Although plastic wrap (PW) can improve neonatal hypothermia by decreasing evaporative heat loss, its effect on mortality and morbidity is uncertain. The aim of the study was to detect if PW can decrease mortality and morbidity in PT infants from 240 to 296 weeks’ gestation. The study design was a retrospective study. The study was conducted at two neonatal intensive care units (NICUs). NICUs medical records from 2021 to 2023. The data were analyzed using logistic regression analysis. A total of 187 PT infants from 240 to 296-week gestation were admitted to both NICUs during that period, 148 PT infants were included in the study. Mean gestational age (GA) was 27.2 ± 2.7 weeks and mean birth weight was 865 ± 375 g; 75 PT infants (51%) were male, and 30 PT infants (20.2%) were hypothermic on admission. After adjusting for risk factors that potentially increased the mortality, admission temperature did not affect the mortality significantly (odds ratio [OR]: 0.8, confidence interval [CI]: 0.6–1.1). The only factor that increased the mortality significantly was GA (OR: 1.1, CI: 1.05–1.4). The other model that tested the effect of admission temperature on the morbidity showed that none of the morbidities were significantly decreased after adjusting for risk factors, necrotizing enterocolitis (OR: 1.05, CI: 0.8–1.3), intraventricular hemorrhage (OR: 0.8, CI: 0.6–1.09), bronchopulmonary dysplasia (OR: 1.1, CI: 0.8–1.3), retinopathy of prematurity (OR: 1.2, CI: 0.9–1.4), and late-onset sepsis (OR: 1.1, CI: 0.9–1.4). PW applied immediately after birth seemed to improve admission temperature in PT infants from 240 to 296-week gestation, but it did not improve neonatal mortality or morbidity.