Nako Y, Harigaya A, Tomomasa T, Morikawa A, Amada M, Kijima C, Tsukagoshi S
Department of Pediatrics, Gunma University School of Medicine, Maebashi, Japan.
Pediatr Int. 2000 Oct;42(5):517-22. doi: 10.1046/j.1442-200x.2000.01282.x.
Because the risks and benefits of early bathing of newborn infants are not well established, we investigated the effects of bathing immediately after birth on rectal temperature, respiratory rate, heart rate, blood pressure, percutaneous arterial blood oxygen saturation (SpO2) and early neonatal morbidity.
The study was designed as a randomized prospective comparative study in the neonatal care unit of a university hospital. A total of 187 healthy term and near-term newborn infants, who were delivered vaginally without asphyxia, between January and December 1997 were the study subjects. We compared findings in newborns who were bathed 2-5 min after birth (n = 95) with those of a control group (n = 92) who received dry care instead. Groups were comparable with respect to gestational age, birthweight, male: female ratio, Apgar score and umbilical blood pH. Rectal temperature was measured with an electronic thermometer immediately before the intervention bathing or dry care and at 30 min and 1, 2, 3, 8 and 12 h after birth. Heart rate, respiratory rate, systolic and diastolic blood pressure and SpO2 were measured at 1, 2, 8 and 12 h after birth. The incidence of early neonatal morbidity, including hyperbilirubinemia and gastrointestinal and respiratory problems, was also compared.
Rectal temperature changed over time postnatally in both groups (P < 0.0001, ANOVA) and there was a significant difference in rectal temperature between groups (P< 0.0001, ANOVA). Mean (+/- SEM) rectal temperature at 30 min after birth (i.e. approximately within 20 min after intervention) was significantly higher in the bathed group than in the control (dry care) group (37.30 +/- 0.06 is 37.00 +/- 0.05 degrees C, respectively; P = 0.000022). Respiratory rate, heart rate, blood pressure and the ratio of the number of infants with SpO2 90-94% and 95-100% did not differ significantly between the two groups. The incidence of early neonatal morbidity, including vomiting, acute gastric mucosal lesion, polycythemia, need for tube feeding, phototherapy and oxygen therapy, also did not differ between the two groups.
Early bathing, minutes after birth, did not appear to adversely affect the adaptation of healthy full-term and near-term newborn infants.
由于新生儿早期沐浴的风险和益处尚未明确，我们研究了出生后立即沐浴对直肠温度、呼吸频率、心率、血压、经皮动脉血氧饱和度（SpO2）及早期新生儿发病率的影响。
本研究设计为一所大学医院新生儿护理单元的随机前瞻性对照研究。1997年1月至12月期间，共有187例健康足月儿和近足月儿经阴道分娩且无窒息，作为研究对象。我们将出生后2 - 5分钟沐浴的新生儿（n = 95）与接受干燥护理的对照组（n = 92）的结果进行比较。两组在胎龄、出生体重、男女比例、阿氏评分及脐血pH值方面具有可比性。在干预性沐浴或干燥护理前及出生后30分钟、1、2、3、8和12小时，用电子温度计测量直肠温度。在出生后1、2、8和12小时测量心率、呼吸频率、收缩压、舒张压及SpO2。还比较了早期新生儿发病率，包括高胆红素血症、胃肠道和呼吸道问题。
两组出生后直肠温度均随时间变化（P < 0.0001，方差分析），且两组间直肠温度存在显著差异（P < 0.0001，方差分析）。出生后30分钟（即干预后约20分钟内），沐浴组的平均（±标准误）直肠温度显著高于对照组（干燥护理组）（分别为37.30 ± 0.06℃和37.00 ± 0.05℃；P = 0.000022）。两组间呼吸频率、心率、血压以及SpO2在90 - 94%和95 - 100%的婴儿数量比例无显著差异。两组间早期新生儿发病率，包括呕吐、急性胃黏膜病变、红细胞增多症、管饲需求、光疗及氧疗，也无差异。
出生后数分钟内的早期沐浴似乎不会对健康足月儿和近足月儿的适应产生不利影响。
