Tsogt Bazarragchaa, Manaseki-Holland Semira, Pollock Jon, Blair Peter S, Fleming Peter
Public Health Institute of Mongolia, Ulaanbaatar, Mongolia.
Public Health, Epidemiology & Biostatistics, University of Birmingham, Birmingham, UK.
Arch Dis Child. 2016 Feb;101(2):152-60. doi: 10.1136/archdischild-2014-307908. Epub 2015 Oct 29.
To investigate thermal balance of infants in a Mongolian winter, and compare the effects of traditional swaddling with an infant sleeping-bag in apartments or traditional tents (Gers).
A substudy within a randomised controlled trial.
Community in Ulaanbaatar, Mongolia.
A stratified randomly selected sample of 40 swaddled and 40 non-swaddled infants recruited within 48 h of birth.
Sleeping-bags and baby outfits of total thermal resistance equivalent to that of swaddled babies.
Digital recordings of infants' core, peripheral, environmental and microenvironmental temperatures at 30-s intervals over 24 h at ages 1 month and 3 months.
In Gers, indoor temperatures varied greatly (<0->25°C), but remained between 20°C and 22°C, in apartments. Despite this, heavy wrapping, bed sharing and partial head covering, infant core and peripheral temperatures were similar and no infants showed evidence of significant heat or cold stress whether they were swaddled or in sleeping-bags. At 3 months, infants in sleeping-bags showed the 'mature' diurnal pattern of a fall in core temperature after sleep onset, accompanied by a rise in peripheral temperature, with a reverse pattern later in the night, just before awakening. This pattern was not related to room temperature, and was absent in the swaddled infants, suggesting that the mature diurnal pattern may develop later in them.
No evidence of cold stress was found. Swaddling had no identifiable thermal advantages over sleeping-bags during the coldest times, and in centrally heated apartments could contribute to the risk of overheating during the daytime.
ISRTN01992617.
调查蒙古冬季婴儿的热平衡情况，并比较传统襁褓与婴儿睡袋在公寓或传统帐篷（蒙古包）中对婴儿的影响。
一项随机对照试验中的子研究。
蒙古乌兰巴托的社区。
出生后48小时内分层随机抽取的40名使用襁褓的婴儿和40名未使用襁褓的婴儿。
总热阻与使用襁褓婴儿相当的睡袋和婴儿服装。
在1个月和3个月大时，每隔30秒对婴儿的核心温度、外周温度、环境温度和微环境温度进行24小时的数字记录。
在蒙古包中，室内温度变化很大（<0->25°C），但在公寓中保持在20°C至22°C之间。尽管如此，通过厚重包裹、同床共眠和部分头部覆盖，无论婴儿是使用襁褓还是睡袋，其核心温度和外周温度相似，没有婴儿出现明显的热应激或冷应激迹象。在3个月大时，使用睡袋的婴儿表现出“成熟”的昼夜模式，即入睡后核心温度下降，外周温度上升，而在夜间晚些时候，即醒来前则呈现相反模式。这种模式与室温无关，且使用襁褓的婴儿没有出现这种模式，这表明使用襁褓的婴儿可能较晚才会出现这种成熟的昼夜模式。
未发现冷应激的证据。在最冷的时候，襁褓与睡袋相比没有明显的热优势，而且在集中供暖的公寓中，襁褓可能会增加白天过热的风险。
ISRTN01992617。
