Management of Healthy Newborn's Body Temperature at Birth

NCT ID: NCT06275932

Last Updated: 2024-02-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

776 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-01

Study Completion Date

2025-05-31

Brief Summary

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At birth, the newborn begins a process of adaptation to extrauterine life. One of the phases of this stabilization process is the maintenance of body temperature; indeed, the newborn passes from a warm environment (mother's womb) of around 37°C to an environment with a temperature lower (delivery room) and, therefore, must implement a series of physiological processes to be able to maintain body temperature constant and within ideal ranges through a balance between production and heat loss.

Hypothermia at birth could cause risks or comorbidities such as an increased risk of infant mortality, hypoglycemia, sepsis, metabolic acidosis, respiratory distress syndrome (RDS) and intraventricular hemorrhage (IVH).

One of the factors that affects heat loss in the delivery room is the relationship between surface area, volume and body mass of the newborn. The decrease in body temperature is directly related to gestational age and weight at birth; indeed, this problem is much more present in premature and/or low weight newborns at birth. Even if a full-term newborn has a more developed thermoregulation center than a preterm newborn, this does not mean that this type of newborns is not at risk heat dispersion.

To date, the strategies that are implemented for the physiological newborn are documented in the literature are, in addition to the heat chain described by the World Health Organization (WHO), the implementation of skin-to-skin contact (skin to skin) mother-newborn.

Some studies demonstrating the beneficial effect of this procedure on maintenance of the newborn's body temperature.

The aim of this study is to evaluate two healthcare interventions to prevent heat loss of healthy newborns at birth.

Detailed Description

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This study is a prospective, randomized controlled trial design which involves the use of two care interventions (experimental vs standard of care) to prevent heat loss of healthy newborns in the delivery room during contact skin to skin after birth.

Study population includes newborns born by natural birth with a gestational age greater than or equal to 37+0 weeks.

Newborns will be randomly assigned to receive: 1) a thermal blanket (experimental group) , or 2) a bed wetting mat and cotton sheet (standard of care group) that cover them during the skin-to-skin contact after birth.

At birth all newborns will receive the same care required by local procedures.

Research hypothesis:

\- the use of a thermal blanket placed on the newborn during the skin-to-skin contact could reduce heat dispersion at the end of the procedure and therefore reduce the percentage of newborns who at the end of skin-to-skin contact have a temperature lower than 36.5°C.

The effectiveness of these interventions will be evaluated by measuring mother and newborn's body temperature at the beginning and the end of skin-to-skin contact.

Conditions

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Newborn, Infant Body Temperature Delivery Room

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Interventional group

All the enrolled newborns will make the skin-to-skin contact with the use of a thermal blanket after birth.

Group Type EXPERIMENTAL

Interventional group

Intervention Type OTHER

Newborns will be covered with a thermal blanket during skin-to-skin contact in delivery room.

Standard of care group

All the enrolled newborns will make the skin-to-skin contact according to local procedure after birth.

Group Type ACTIVE_COMPARATOR

Standard of care group

Intervention Type OTHER

Newborns will be covered with a bed wetting mat and cotton sheet during skin-to-skin contact in delivery room.

Interventions

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Interventional group

Newborns will be covered with a thermal blanket during skin-to-skin contact in delivery room.

Intervention Type OTHER

Standard of care group

Newborns will be covered with a bed wetting mat and cotton sheet during skin-to-skin contact in delivery room.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

For mother

* Mothers' age over 18 years and good comprehension of Italian language;
* Signed informed consent of the mother.

For newborn

* Informed consent signed by both parents, or in the case of a single-parent family, by mother
* Gestational age at birth greater than or equal to 37+0 weeks
* Newborns from singleton pregnancies;
* Both male and female newborns;
* Newborns who will be born from vaginal birth.

Exclusion Criteria

For mother

* Mothers who do not want to carry out skin-to-skin contact;
* Mothers who do not understand/speak the Italian language;
* Mothers who need assistance procedures that hinder skin-to-skin contact.

For newborn

* Newborns whose parents decline participation in the study;
* Newborns with major congenital anomalies (heart, brain, metabolic, gastrointestinal);
* Newborns born via cesarean section;
* Newborns whose parents are under 18 years old, in the case of a single parent the mother who is under 18 years;
* Newborns requiring neonatal resuscitation after birth with obstruction of the skin-to-skin contact.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gabriele Sorrentino, pedRN

Role: PRINCIPAL_INVESTIGATOR

Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico

Locations

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Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Milan, , Italy

Site Status

Countries

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Italy

Central Contacts

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Gabriele Sorrentino, pedRN

Role: CONTACT

+393496060149

Facility Contacts

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Gabriele Sorrentino, pedRN

Role: primary

+393496060149

References

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Sharma D. Golden hour of neonatal life: Need of the hour. Matern Health Neonatol Perinatol. 2017 Sep 19;3:16. doi: 10.1186/s40748-017-0057-x. eCollection 2017.

Reference Type BACKGROUND
PMID: 28932408 (View on PubMed)

Manani M, Jegatheesan P, DeSandre G, Song D, Showalter L, Govindaswami B. Elimination of admission hypothermia in preterm very low-birth-weight infants by standardization of delivery room management. Perm J. 2013 Summer;17(3):8-13. doi: 10.7812/TPP/12-130.

Reference Type BACKGROUND
PMID: 24355884 (View on PubMed)

Trevisanuto D, Testoni D, de Almeida MFB. Maintaining normothermia: Why and how? Semin Fetal Neonatal Med. 2018 Oct;23(5):333-339. doi: 10.1016/j.siny.2018.03.009. Epub 2018 Mar 21.

Reference Type BACKGROUND
PMID: 29599071 (View on PubMed)

World Health Organization. Thermal protection of the newborn: a practical guide. Published online 1997.

Reference Type BACKGROUND

Duryea EL, Nelson DB, Wyckoff MH, Grant EN, Tao W, Sadana N, Chalak LF, McIntire DD, Leveno KJ. The impact of ambient operating room temperature on neonatal and maternal hypothermia and associated morbidities: a randomized controlled trial. Am J Obstet Gynecol. 2016 Apr;214(4):505.e1-505.e7. doi: 10.1016/j.ajog.2016.01.190. Epub 2016 Feb 10.

Reference Type BACKGROUND
PMID: 26874298 (View on PubMed)

Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2012 May 16;5(5):CD003519. doi: 10.1002/14651858.CD003519.pub3.

Reference Type BACKGROUND
PMID: 22592691 (View on PubMed)

Related Links

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http://www.ncbi.nlm.nih.gov/books/NBK190086/

WHO Recommendations on Postnatal Care of the Mother and Newborn. World Health Organization

Other Identifiers

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TermoNeo/2023

Identifier Type: -

Identifier Source: org_study_id

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