title: Plastic bags for prevention of hypothermia in preterm and low birth weight infants.
abstract: OBJECTIVE
  Hypothermia contributes to neonatal mortality and morbidity, especially in preterm and low birth weight infants in developing countries. Plastic bags covering the trunk and extremities of very low birth weight infants reduces hypothermia. This technique has not been studied in larger infants or in many resource-limited settings. The objective was to determine if placing preterm and low birth weight infants inside a plastic bag at birth maintains normothermia.
  
  
  METHODS
  Infants at 26 to 36 weeks' gestational age and/or with a birth weight of 1000 to 2500 g born at the University Teaching Hospital in Lusaka, Zambia, were randomized by using a 1:1 allocation and parallel design to standard thermoregulation (blanket or radiant warmer) care or to standard thermoregulation care plus placement inside a plastic bag at birth. The primary outcome measure was axillary temperature in the World Health Organization-defined normal range (36.5-37.5°C) at 1 hour after birth.
  
  
  RESULTS
  A total of 104 infants were randomized. At 1 hour after birth, infants randomized to plastic bag (n = 49) were more likely to have a temperature in the normal range as compared with infants in the standard thermoregulation care group (n = 55; 59.2% vs 32.7%; relative risk 1.81; 95% confidence interval 1.16-2.81; P = .007). The temperature at 1 hour after birth in the infants randomized to plastic bag was 36.5 ± 0.5°C compared with 36.1 ± 0.6°C in standard care infants (P < .001). Hyperthermia (>38.0°C) did not occur in any infant.
  
  
  CONCLUSIONS
  Placement of preterm/low birth weight infants inside a plastic bag at birth compared with standard thermoregulation care reduced hypothermia without resulting in hyperthermia, and is a low-cost, low-technology tool for resource-limited settings.
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL 35249-7335, USA.
authors.forename: Alicia E
authors.initials: AE
authors.lastname: Leadford
authors.forename: Jamie B
authors.initials: JB
authors.lastname: Warren
authors.forename: Albert
authors.initials: A
authors.lastname: Manasyan
authors.forename: Elwyn
authors.initials: E
authors.lastname: Chomba
authors.forename: Ariel A
authors.initials: AA
authors.lastname: Salas
authors.forename: Robert
authors.initials: R
authors.lastname: Schelonka
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Carlo
mesh_terms: D001833:Body Temperature Regulation; D003906:Developing Countries; D004311:Double-Blind Method; D005260:Female; D005865:Gestational Age; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000517:prevention & control*; D007230:Infant, Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D018743:Perinatal Care / Q000379:methods*; D020959:Polyethylene; D015024:Zambia
chemical_list: D020959:Polyethylene
keywords: diseases/prevention and control; hypothermia/prevention and control; infant newborn; infant premature; perinatal care/methods