Key Points

Question  Of the thermal care interventions available in the delivery room, which is the most appropriate for reducing hypothermia and improving clinical outcomes in preterm neonates?

Findings  In this network meta-analysis of 34 trials involving 3688 newborns and 9 interventions, a combination of plastic bag or wrap with a plastic cap or with heated humidified respiratory gas was associated with reduced risk of mortality before discharge and major brain injury while stabilizing the core body temperature immediately after birth. Certainty of evidence for these interventions was moderate for temperature stabilization and low to moderate for other clinical outcomes.

Meaning  In this study, delivery room use of a plastic bag or wrap with a plastic cap or with heated humidified gas appeared to be the appropriate thermal care intervention for preterm neonates.


Importance  Prevention of hypothermia in the delivery room is a cost-effective, high-impact intervention to reduce neonatal mortality, especially in preterm neonates. Several interventions for preventing hypothermia in the delivery room exist, of which the most beneficial is currently unknown.

Objective  To identify the delivery room thermal care intervention that can best reduce neonatal hypothermia and improve clinical outcomes for preterm neonates born at 36 weeks’ gestation or less…more