Improving Thermal Support in Very and Extremely Low Birth Weight Infants During Interfacility Transport

Background: Very low birth weight (VLBW) and extremely low birth weight (ELBW) infants are at high risk of hypothermia during interfacility transport, which can lead to increased morbidity and mortality. Effective thermal support strategies are essential to prevent heat loss and improve outcomes for these vulnerable neonates. Objective: To evaluate the effectiveness of various thermal support strategies in preventing hypothermia among VLBW and ELBW infants during interfacility transport. Methods: This prospective observational study was conducted at Anugrah Narayan Magadh Medical College & Hospital (ANMMCH), Gaya, Bihar, from April 2022 to June 2023. A total of 125 VLBW and ELBW infants were transported using various thermal support interventions, including transport incubators, heated blankets, double-layering, and skin-to-skin contact. Pre- and post-transport temperatures were recorded to assess the incidence of hypothermia. Results: The incidence of hypothermia increased from 15% pre-transport to 45% post-transport. Combining transport incubators with additional thermal support significantly reduced hypothermia rates, with skin-to-skin contact and incubator use showing the lowest rate (25%). Conclusion: Multi-layered thermal support strategies, particularly those combining skin-to-skin contact with incubator use, were more effective in reducing hypothermia in transported VLBW and ELBW infants. Standardized protocols incorporating these strategies could improve outcomes in neonatal transport.