Thermal management for premature births


  • Sandie Bredemeyer OAM PhD RN RM FCN,

  • Shelley Reid BA BAppSc RN RM,

  • Michele Wallace RN RM

Sandie Bredemeyer,
RPA Women and Babies Centre for
Midwifery and Nursing Research,
RPA Newborn Care,
Royal Prince Alfred Hospital/University of Sydney,
Level 3 Missenden Rd,
New South Wales 2050,


Aim.  This paper reports an audit of the effect on admission temperatures of using occlusive polyethylene wrap applied immediately after the birth of extremely premature infants.

Background.  Use of occlusive polyethylene wrap during the early postnatal management of the premature infant reduces evaporative and convective heat loss.

Method.  Retrospective preintervention audit was carried out, followed by the introduction of occlusive polyethylene wrap for thermal management during resuscitation and early stabilization. Prospective postintervention audit was then performed. The preintervention (control) group infants were immediately dried with prewarmed towels and resuscitated under radiant heat. Infants in the intervention group were managed under radiant heat, were not dried but were immediately enclosed in an occlusive polyethylene wrap.

Results.  The demographic characteristics of the two groups were comparable. Use of occlusive polyethylene wrap resulted in higher admission temperatures for infants less than 27 weeks gestation (z = 108·50, P < 0·01). There was no statistically significant improvement in admission temperatures for 27–29 week infants. The rate of hypothermia on admission (<35·6°C per axilla) was lower in the intervention group (χ2 = 5·12, d.f. = 1, P = 0·02), but more infants recorded temperatures exceeding 37·2°C during the first 12 hours (χ2 = 23·45, d.f. = 1, P < 0·01). There were no other adverse effects noted.

Conclusion.  Use of occlusive polyethylene wrap improved admission temperatures for infants less than 27 weeks gestation. This intervention is easy to implement and does not interfere with resuscitation. However, removal of the wrap should be considered following admission to a closed care system in the neonatal intensive care unit because, in the intervention group, hyperthermia in the first 12 hours was a potential side effect.