title: A randomized trial of exothermic mattresses for preterm newborns in polyethylene bags.
abstract: OBJECTIVE
  Hypothermia on admission to the NICU is associated with increased mortality in preterm infants. Many newborns are hypothermic on admission despite using polyethylene bags (PBs). Using exothermic mattresses (EMs) in addition to PBs may reduce hypothermia but increase hyperthermia. We wished to determine whether placing preterm newborns in PBs on EMs in the DR results in more infants with rectal temperature outside the range 36.5 to 37.5°C on NICU admission.
  
  
  METHODS
  Infants <31 weeks were randomly assigned before birth to treatment with or without an EM. All infants were placed in a PB and under radiant heat immediately after birth and brought to NICU in a transport incubator. Infants randomly assigned to EM were placed on a mattress immediately after delivery and remained on it until admission. Randomization was stratified by gestational age. Rectal temperature was measured with a digital thermometer on NICU admission.
  
  
  RESULTS
  The data safety monitoring committee recommended stopping for efficacy after analyzing data from half the planned sample. We report data for 72 infants enrolled at this time. Fewer infants in PBs on EMs had temperatures within the target range (15/37 [41%] vs 27/35 [77%], P = .002) and more had temperatures >37.5°C (17/37 [46%] vs 6/35 [17%], P = .009).
  
  
  CONCLUSIONS
  In very preterm newborns, using EMs in addition to PBs in the DR resulted in more infants with temperatures outside the normal range and more hyperthermia on NICU admission.
authors.affiliation: The National Maternity Hospital, Holles Street, Dublin, Ireland.
authors.forename: Lisa K
authors.initials: LK
authors.lastname: McCarthy
authors.forename: Eleanor J
authors.initials: EJ
authors.lastname: Molloy
authors.forename: Anne R
authors.initials: AR
authors.lastname: Twomey
authors.forename: John F A
authors.initials: JF
authors.lastname: Murphy
authors.forename: Colm P F
authors.initials: CP
authors.lastname: O'Donnell
mesh_terms: D001513:Beds; D001833:Body Temperature Regulation / Q000502:physiology; D005260:Female; D018857:Food Packaging; D005865:Gestational Age; D006361:Heating / Q000379:methods*; D006771:Hospitals, Maternity; D006801:Humans; D007035:Hypothermia / Q000503:physiopathology / Q000517:prevention & control*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000503:physiopathology / Q000517:prevention & control*; D007363:Intensive Care Units, Neonatal; D007494:Ireland; D008297:Male; D018743:Perinatal Care / Q000379:methods*; D020959:Polyethylene
chemical_list: D020959:Polyethylene
keywords: exothermic mattress; hypothermia; infant; newborn; polyethylene bag; premature; randomized trial; thermoregulation