Abstract
Objective
The objective of this study is to evaluate the corrected age and weight that infants were transferred into an open cot using a heated mattress, in overall and within the subgroups of early (weight ≤ 1400 g) and standard transfer (weight > 1400 g).
Design
Retrospective cohort study in a tertiary neonatal unit
Results
One hundred and thirty-five preterm infants were analysed. The mean weight of moving into an open cot was 1370 ± 167 g at a corrected age 33 ± 1.8 weeks. Eighty-three infants (61%) were transferred early at a mean weight 1276 ± 98 g compared with 52 infants of standard transfer with a mean weight 1522 ± 141 g. Infants of the early group had higher weight gain, were discharged earlier and had shorter length of stay.
Conclusions
Stable preterm infants can be safely moved to an open cot at < 33 weeks and weight ≤ 1400 g.
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References
Sutter TW, Phan D, Pierchala CE, Rishel W. Weaning of premature infants from the incubator to an open crib. J Perinatol. 1988;8:193–8.
Gray PH, Flenady V. Cot-nursing versus incubator care for preterm infants. Cochrane Database Syst Rev. 2011: CD003062.
Jackson K, Ternestedt BM, Schollin J. From alienation to familiarity: experiences of mothers and fathers of preterm infants. J Adv Nurs. 2003;43:120–9.
American Academy of Pediatrics, American College of Obstetricians and Gynecologists. Guidelines for perinatal care. 8th ed. American Academy of Pediatrics, The American College of Obstetricians and Gynecologists: Elk Grove Village, IL Washington, DC; 2017.
Ehrenkranz RA, Walsh MC, Vohr BR, Jobe AH, Wright LL, Fanaroff AA, et al. Validation of the National Institutes of Health consensus definition of bronchopulmonary dysplasia. Pediatrics. 2005;116:1353–60.
Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978;92:529–34.
International Committee for the Classification of Retinopathy of P. The International classification of retinopathy of prematurity revisited. Arch Ophthalmol. 2005;123:991–9.
Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am. 1986;33:179–201.
Barone G, Corsello M, Papacci P, Priolo F, Romagnoli C, Zecca E. Feasibility of transferring intensive cared preterm infants from incubator to open crib at 1600 grams. Ital J Pediatr. 2014;40:41.
Gray PH, Paterson S, Finch G, Hayes M. Cot-nursing using a heated, water-filled mattress and incubator care: a randomized clinical trial. Acta Paediatr. 2004;93:350–5.
Heimler R, Sumners JE, Grausz JP, Kien CL, Glaspey JC. Thermal environment change in growing premature infants: effect on general somatic growth and subcutaneous fat accumulation. Pediatrics. 1981;68:82–86.
New K, Flint A, Bogossian F, East C, Davies MW. Transferring preterm infants from incubators to open cots at 1600 g: a multicentre randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 2012;97:F88–92.
Sarman I, Tunell R. Providing warmth for preterm babies by a heated, water filled mattress. Arch Dis Child. 1989;64(1 Spec No):29–33.
Schneiderman R, Kirkby S, Turenne W, Greenspan J. Incubator weaning in preterm infants and associated practice variation. J Perinatol. 2009;29:570–4.
Shankaran S, Bell EF, Laptook AR, Saha S, Newman NS, Kazzi SNJ, et al. Weaning of moderately preterm infants from the incubator to the crib: a randomized clinical trial. J Pediatr. 2018;204:96-102.
West CR, Williams M, Weston PJ. Feasibility and safety of early transfer of premature infants from incubators to cots: a pilot study. J Paediatr Child Health. 2005;41:659–62.
Zecca E, Corsello M, Priolo F, Tiberi E, Barone G, Romagnoli C. Early weaning from incubator and early discharge of preterm infants: randomized clinical trial. Pediatrics. 2010;126:e651–656.
New K, Flenady V, Davies MW. Transfer of preterm infants from incubator to open cot at lower versus higher body weight. Cochrane Database Syst Rev. 2011: CD004214.
Saenz P, Cerda M, Diaz JL, Yi P, Gorba M, Boronat N, et al. Psychological stress of parents of preterm infants enrolled in an early discharge programme from the neonatal intensive care unit: a prospective randomised trial. Arch Dis Child Fetal Neonatal Ed. 2009;94:F98–F104.
Weintraub V, Mimouni FB, Dollberg S. Changes in energy expenditure in preterm infants during weaning: a randomized comparison of two weaning methods from an incubator. Pediatr Res. 2007;61:341–4.
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This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
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DR contributed to the study design, the data analysis and interpretation, and the manuscript preparation. CL contributed to the data collection and the critical revision of the manuscript. AK contributed to the study design and the critical revision of the manuscript.
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Rallis, D., Longley, C. & Kage, A. Transferring preterm infants into an open cot using a heated mattress at ≤ 1400 g. J Perinatol 39, 1399–1405 (2019). https://doi.org/10.1038/s41372-019-0453-3
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DOI: https://doi.org/10.1038/s41372-019-0453-3


