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. 2016 May;36 Suppl 1(Suppl 1):S83-9.
doi: 10.1038/jp.2016.35.

The effect of coverings, including plastic bags and wraps, on mortality and morbidity in preterm and full-term neonates

H K Oatley  1 , H Blencowe  1   2 , J E Lawn  1   2   3
Affiliations

The effect of coverings, including plastic bags and wraps, on mortality and morbidity in preterm and full-term neonates

H K Oatley et al. J Perinatol. 2016 May.

Abstract

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.

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Figures

Figure 1
Figure 1
Search results with inclusions and exclusions.
Figure 2
Figure 2
Meta-analysis of six RCTs of plastic wraps in preterm neonates ⩽29 weeks on neonatal mortality (N=433). CI, confidence interval; RCT, randomized controlled trial; RR, risk ratio.
Figure 3
Figure 3
Meta-analysis of four RCTs of plastic wraps in preterm neonates ⩽29 weeks on hypothermia (N=321). CI, confidence interval; RCT, randomized controlled trial; RR, risk ratio.
See this image and copyright information in PMC

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