![]() ![]() Overall five mothers had temperatures above 37.5☌ during delivery and two of the infants were febrile (see above). Two of the mothers were febrile and the third had bacterial vaginosis. There was evidence of infection in the mothers of all three infants affected. None of the variables listed above (including birth weight) had a significant association with temperature outside the 36.5–37.5☌ range.Īdmission temperature was above the set limit (37.5☌) in three (5%) of the infants. Admission temperature was associated with birth weight on conditional linear regression-no other variables ( including, antenatal steroid use, delivery method, maternal temperature, gestation, gender, SGA, Apgar scores, intubation at delivery, transport device or time to arrival) displayed a significant association. ![]() The interquartile range was wider and the coefficient of variation of admission temperature higher in the incubator group. Median axillary temperature on admission was 36.8☌ in both groups. Of 14 infants with gestation 23–24 weeks, three had admission temperatures below 36☌. Eight infants had admission temperatures between 35.5–35.9☌ and eight were between 36–36.4☌. The lowest recorded admission temperature was 35.4☌ (incubator transport). Statistics were Chi square or Fisher's exact test for proportions, Mann Whitney U test for nonparametric measures and linear regression for factors associated with admission temperature. For multiple births, each baby was allocated a separate envelope. Allocation to transport device was with sequentially numbered opaque sealed envelopes. Randomisation was stratified into 23–25 weeks and a group 26–27 weeks (block size 10 random numbers computer generated). To detect a 35% difference (suggested by the pilot study and one deemed clinically significant), 29 infants were required for each group (α 0.05, β 0.8). Sample size was determined from a separate pilot study 43% of 21 infants <1000 g transported either by warmer or incubator were admitted with temperatures outside the desired range of 36.5–37.5☌. 2, 3 Secondary outcomes were interference with resuscitation, skin infection or 5 day course of antibiotics in the first week, respiratory support requirements, length of stay, chronic lung disease, necrotising enterocolitis, severe intraventricular haemorrhage, retinopathy of prematurity and death. Primary outcome was the proportion with axillary temperature in the target range of 36.5–37.5☌. Axillary temperatures were measured immediately with digital electronic thermometers (Becton Dickinson, Auckland, New Zealand) and skin servocontrol commenced. ![]() In the nursery infants were weighed (wrapped) and placed on a warmer. Skin servocontrol was not used before arrival to the nursery. Heater output of the warmer was 100% throughout and incubator air temperature was set at 39☌ and was 39☌ at the start of the transfer. Infants were transported (wrapped) on either a radiant warmer (Fisher & Paykel Cos圜ot) with power source or in an incubator (Caleo, Drager, Biolab, Auckland, New Zealand) with power supply all received mask CPAP. Once stable, infants were moved from delivery or theatre to the neonatal unit, a 5–7 min trip. Ambient temperatures in delivery suite, theatre and the neonatal unit were maintained at 25☌. Resuscitation was consistent with current American Heart Association guidelines. The infant (undried) was placed on the radiant warmer (heater output 100%) in the middle of the sheet and the sides closed over the limbs and trunk. ![]() Following delivery the infant was placed on a radiant warmer and wrapped with occlusive polyethylene (NeoWrap, Fisher & Paykel Healthcare, Auckland, New Zealand). Infants 23–27 weeks gestation admitted to the neonatal unit were eligible provided there was no suspected congenital infection, major congenital abnormality or open skin defect. ![]()
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