Oatley H K, Blencowe H, Lawn J E
Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Centre for Maternal, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, UK.
J Perinatol. 2016 May;36 Suppl 1(Suppl 1):S83-9. doi: 10.1038/jp.2016.35.
Neonatal hypothermia is an important risk factor for mortality and morbidity, and is common even in temperate climates. We conducted a systematic review to determine whether plastic coverings, used immediately following delivery, were effective in reducing the incidence of mortality, hypothermia and morbidity. A total of 26 studies (2271 preterm and 1003 term neonates) were included. Meta-analyses were conducted as appropriate. Plastic wraps were associated with a reduction in hypothermia in preterm (⩽29 weeks; risk ratio (RR)=0.57; 95% confidence interval (CI) 0.46 to 0.71) and term neonates (RR=0.76; 95% CI 0.60 to 0.96). No significant reduction in neonatal mortality or morbidity was found; however, the studies were underpowered for these outcomes. For neonates, especially preterm, plastic wraps combined with other environmental heat sources are effective in reducing hypothermia during stabilization and transfer within hospital. Further research is needed to quantify the effects on mortality or morbidity, and investigate the use of plastic coverings outside hospital settings or without additional heat sources.
新生儿低体温是导致死亡率和发病率的一个重要风险因素，即便在温带气候地区也很常见。我们进行了一项系统评价，以确定分娩后立即使用塑料覆盖物是否能有效降低死亡率、低体温和发病率。总共纳入了26项研究（2271例早产儿和1003例足月儿）。酌情进行了荟萃分析。塑料包裹与早产儿（孕周≤29周；风险比（RR）=0.57；95%置信区间（CI）0.46至0.71）和足月儿低体温的降低有关（RR=0.76；95%CI 0.60至0.96）。未发现新生儿死亡率或发病率有显著降低；然而，这些研究针对这些结局的效能不足。对于新生儿，尤其是早产儿，塑料包裹与其他环境热源相结合可有效降低在医院内稳定病情和转运期间的低体温。需要进一步研究以量化对死亡率或发病率的影响，并调查在院外环境或无额外热源情况下使用塑料覆盖物的情况。
