This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Thermoregulation is an important determinant of the survival of very immature infants (i.e., <28 weeks gestation). The optimal temperature range for any infant (term or preterm) is one that minimizes stress and metabolic consumption. If the infant's temperature falls below the lower limit of the optimal temperature range the infant is at risk of hypothermia and any associated complications. Several risk factors are associated with neonatal hypothermia including an increase in morbidity from infection, abnormal coagulation, post-delivery acidosis, delayed readjustment from the fetal to newborn circulation, and respiratory distress syndrome. Very immature infants are particularly vulnerable to heat loss because they lack subcutaneous fat, have an increased surface area to body weight ratio, exhibit poor vasomotor control in the first two or three days of life, and have immature stratum corneum that is relatively deficient in keratin content. In an attempt to reduce heat loss and therefore increase the chances of survival in the premature infant, several inventive protocols and procedures have been proposed and put into practice. Presently, the standard of care for reducing heat loss following birth is to immediately dry newborns under radiant heat. Although this method has been shown to significantly reduce heat loss, there is still considerable room for improvement. This study hypothesizes that occlusive skin wrapping of premature infants under a preheated radiant warmer is more effective than conventional drying for preventing mortality and morbidity related to hypothermia in the premature infant.
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