Objective Hypothermia on admission to the neonatal intensive care unit (NICU) is associated with an increased risk of death in preterm infants. There are currently no evidence-based recommendations for thermal care before cord clamping (CC). We wished to determine whether placing very preterm infants in a polyethylene bag (PB) before CC, compared with after CC, results in more infants with a temperature in the normal range on NICU admission. Design Randomised controlled trial. Setting Tertiary maternity hospital. Patients Inborn infants<32 weeks’ gestational age (GA). Interventions Infants were randomly assigned to have a PB placed before or after CC. Main outcome Rectal temperature within the normal range (36.5°C–37.5°C) on NICU admission. Results Between July 2020 and September 2022, 198/220 (90%) eligible infants were enrolled in this study; 99 (44 (44%) girls) were randomly assigned to BEFORE and 99 (53 (54%) girls) to AFTER. Median (IQR) GA 29 (27–31) vs 29 (27–31) weeks, mean (SD) birth weight 1206 (429) vs 1138 (419) g, respectively. The proportion of infants who had normal temperature on NICU admission did not differ between the groups (BEFORE 54/99 (55%) vs AFTER 55/98 (56%), p 0.824). The proportion of infants with a temperature outside of the normal range was similar between the groups; hypothermia (BEFORE 34/99 (34%) vs AFTER 33/98 (34%), hyperthermia (BEFORE 10/99 (10%) vs AFTER 10/98 (10%)). Conclusions Placing a PB before CC did not increase the proportion of preterm infants with normal temperature on NICU admission. A large proportion of preterm infants had abnormal temperature. Further studies on thermoregulation before CC are needed. Trial registration number [NCT04463511][1] Data are available upon reasonable request. Data will be made available upon reasonable request. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04463511.&atom=%2Ffetalneonatal%2F109%2F3%2F317.atom

中文翻译：

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极早产儿脐带夹闭前使用聚乙烯袋：一项随机对照试验

目的 新生儿重症监护病房 (NICU) 入院时体温过低与早产儿死亡风险增加相关。目前尚无针对脐带夹紧 (CC) 前热护理的循证建议。我们希望确定与 CC 后相比，在 CC 前将极早产儿放入聚乙烯袋 (PB) 中是否会导致更多婴儿在 NICU 入院时体温处于正常范围内。设计随机对照试验。设置三级妇产医院。患者 孕龄 (GA) <32 周的出生婴儿。干预措施 婴儿被随机分配在 CC 之前或之后放置 PB。主要结果 NICU 入院时直肠温度在正常范围内 (36.5°C–37.5°C)。结果 2020年7月至2022年9月期间，198/220（90%）名符合条件的婴儿参加了本研究； 99 名（44 名（44%）女孩）被随机分配到之前，99 名（53 名（54%）女孩）被随机分配到之后。中位 (IQR) GA 29 (27–31) 和 29 (27–31) 周，平均 (SD) 出生体重分别为 1206 (429) 和 1138 (419) g。入院 NICU 时体温正常的婴儿比例在各组之间没有差异（之前 54/99 (55%) vs 之后 55/98 (56%)，p = 0.824）。各组之间体温超出正常范围的婴儿比例相似；体温过低（34/99 之前 (34%) vs 33/98 之后 (34%)，体温过高（10/99 之前 (10%) vs 10/98 之后 (10%)）。结论 在 CC 之前放置 PB 并没有增加NICU 入院时体温正常的早产儿比例 大部分早产儿在 CC 前体温调节情况需要进一步研究，试验注册号 [NCT04463511][1] 可根据合理要求提供数据。根据合理要求提供[1]：/lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04463511.&atom=%2Ffetalneonatal%2F109%2F3%2F317.atom