Standard care with plastic bag or portable thermal nest to prevent hypothermia at birth: a three-armed randomized controlled trial.

Objective: To assess the efficacy of adding plastic bag or portable thermal nest (PTN) to standard care in preventing hypothermia soon after birth in 1500-2499 g infants.

Methods: Infants were randomized into standard thermal care alone, plastic bag with standard care or PTN with standard care. Axillary temperature was measured at admission and every 30 min till euthermia. All babies were followed-up till day 7.

Results: We recruited 300 infants: plastic bag (101), PTN (99) and standard care group (100). Admission temperature was 36.4 °C (0.52) in plastic bag group, 36.3 °C (0.50) in PTN and 36.1 °C (0.59) in standard care group (p < 0.001). Incidence of hypothermia was lowest in plastic bag group (44.6%), followed by PTN (60%) and standard care (67%). Secondary outcomes were comparable.

Conclusion: Addition of plastic bag or PTN to standard care significantly reduces incidence and duration of hypothermia soon after birth. Plastic bag is more effective than PTN.