{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T17:17:15Z","timestamp":1772558235285,"version":"3.50.1"},"reference-count":29,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Despite continuous improvements in neonatal resuscitation and stabilization in the last decades, thermal management immediately after birth remains an unresolved issue in preterm infants.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare 2 strategies of thermal management (plastic wrapping with or without drying) for preventing heat loss at birth in very preterm infants.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This multicenter, unblinded, randomized clinical trial was conducted among very preterm infants (birth weight &amp;lt;1500 g and\/or gestational age \u226430 weeks 6 days) at 21 tertiary care hospitals in Italy from February 21, 2023, to July 18, 2024.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Eligible neonates were randomly allocated to either drying before plastic wrapping in the delivery room (intervention arm) or plastic wrapping without drying (control arm).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was the proportion of participants with normothermia (36.5-37.5 \u00b0C) at admission to the neonatal intensive care unit (NICU). The secondary outcomes included hypothermia (&amp;lt;36.5 \u00b0C), moderate to severe hypothermia (&amp;lt;36.0 \u00b0C), and hyperthermia (&amp;gt;37.5 \u00b0C) at NICU admission, temperature at 1 hour after NICU admission, intraventricular hemorrhage, respiratory distress syndrome, late-onset sepsis, bronchopulmonary dysplasia, and mortality before hospital discharge.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Overall, 354 very preterm infants were randomized (180 [50.8%] female; mean [SD] gestational age, 28.6 [2.5] weeks); all received the allocated intervention and were included in the analysis. Normothermia at NICU admission was achieved in 81 of 177 dried infants (45.8%) and 82 of 177 undried infants (46.3%; risk ratio, 0.99; 95% CI, 0.79-1.24). The mean (SD) neonatal temperature at NICU admission was 36.4 \u00b0C (0.8 \u00b0C) in dried neonates and 36.5 \u00b0C (0.7 \u00b0C) in undried neonates (mean difference, \u22120.1 \u00b0C; 95% CI, \u22120.2 \u00b0C to 0.1 \u00b0C). In-hospital mortality included 26 of 177 dried neonates (14.7%) and 10 of 177 undried neonates (5.6%) (unadjusted risk ratio, 2.60; 95% CI, 1.29-5.23). The other secondary outcome measures were not different between the 2 arms.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this multicenter randomized clinical trial, drying before plastic wrapping provided no benefit to very preterm infants in maintaining normothermia at NICU admission. Most deaths could be expected due to the compromised profile of the neonates, with no pathophysiological explanation related to the trial interventions. Approximately half of the infants were outside the normal thermal range at NICU admission; hence, thermal management remains a challenge requiring further investigations.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT05740072<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.56902","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:00:16Z","timestamp":1772553616000},"page":"e2556902","source":"Crossref","is-referenced-by-count":0,"title":["Drying Very Preterm Infants Before Plastic Wrapping at Birth"],"prefix":"10.1001","volume":"9","author":[{"given":"Francesco","family":"Cavallin","sequence":"first","affiliation":[{"name":"Independent statistician, Solagna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicoletta","family":"Doglioni","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Neonatal Intensive Care Unit, University Hospital of Padova, Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco Maria","family":"Risso","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Children\u2019s Hospital, Azienda Socio Sanitaria Territoriale Spedali Civili, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo Bernardo","family":"Monari","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Neonatal Intensive Care Unit, University Hospital of Padova, Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Aversa","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Children\u2019s Hospital, Azienda Socio Sanitaria Territoriale Spedali Civili, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Troiani","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Dipartimento Materno Infantile, Santa Maria della Misericordia Hospital, Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Battajon","sequence":"additional","affiliation":[{"name":"Critical Care Department, Ospedale Regionale Ca Foncello, Treviso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabino","family":"Moschella","sequence":"additional","affiliation":[{"name":"L\u2019Unit\u00e0 Operativa Complessa Neonatologia e Terapia Intensiva Neonatale, Dipartimento Materno-Infantile, Azienda Ospedaliera di Rilievo Nazionale Moscati, Avellino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo Ernesto","family":"Villani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Fondazione Poliambulanza, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Vedovato","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, San Bortolo Hospital, Vicenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danuska","family":"Maiorca","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Sant\u2019Anna Hospital, Citt\u00e0 della Salute e della Scienza, Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simonetta","family":"Frezza","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. 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