Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial

Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight. Study Design: This trial was conducted in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweight <1600 g, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0°C to 1.5°C every 24 hours until 28.0°C. The infants were weaned to the crib following stable temperature at 36.5°C to 37.4°C for 8 to 12 hours. Clothing and bedcoverings were standardized. The primary outcome was length of hospital stay from birth to discharge; secondary outcomes included length of stay and growth velocity from weaning to discharge. Adverse events were monitored. Results: Of 1565 infants screened, 885 were eligible, and 366 enrolled—187 to the 1600-g and 179 to the 1800-g group. Maternal and neonatal characteristics did not differ among weight groups. Length of hospital stay was a median of 43 days in the lower and 41 days in the higher weight group (P =.12). Growth velocity from completion of weaning to discharge was higher in the lower weight group, 13.7 g/kg/day vs 12.8 g/kg/day (P =.005). Groups did not differ in adverse events. Conclusions: Among moderately preterm neonates, weaning from incubator to crib at a lower weight did not decrease length of stay, but was safe and was accompanied by higher weight gain after weaning. Trial Registration: ClinicalTrials.gov NCT02160002.

Original languageEnglish (US)
JournalJournal of Pediatrics
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Fingerprint

Infant Incubators
Infant Equipment
Weaning
Premature Infants
Length of Stay
Randomized Controlled Trials
Weights and Measures
Incubators
National Institute of Child Health and Human Development (U.S.)
Temperature
Clothing
Growth
Gestational Age
Weight Gain
Mothers
Parturition
Newborn Infant

Keywords

  • incubator
  • moderately preterm infants
  • randomized controlled trial
  • temperature
  • weaning

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network (Accepted/In press). Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial. Journal of Pediatrics. https://doi.org/10.1016/j.jpeds.2018.08.079

Weaning of Moderately Preterm Infants from the Incubator to the Crib : A Randomized Clinical Trial. / Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network.

In: Journal of Pediatrics, 01.01.2018.

Research output: Contribution to journalArticle

Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network 2018, 'Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial', Journal of Pediatrics. https://doi.org/10.1016/j.jpeds.2018.08.079
Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network. Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial. Journal of Pediatrics. 2018 Jan 1. https://doi.org/10.1016/j.jpeds.2018.08.079
Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network. / Weaning of Moderately Preterm Infants from the Incubator to the Crib : A Randomized Clinical Trial. In: Journal of Pediatrics. 2018.
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abstract = "Objective: To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight. Study Design: This trial was conducted in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweight <1600 g, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0°C to 1.5°C every 24 hours until 28.0°C. The infants were weaned to the crib following stable temperature at 36.5°C to 37.4°C for 8 to 12 hours. Clothing and bedcoverings were standardized. The primary outcome was length of hospital stay from birth to discharge; secondary outcomes included length of stay and growth velocity from weaning to discharge. Adverse events were monitored. Results: Of 1565 infants screened, 885 were eligible, and 366 enrolled—187 to the 1600-g and 179 to the 1800-g group. Maternal and neonatal characteristics did not differ among weight groups. Length of hospital stay was a median of 43 days in the lower and 41 days in the higher weight group (P =.12). Growth velocity from completion of weaning to discharge was higher in the lower weight group, 13.7 g/kg/day vs 12.8 g/kg/day (P =.005). Groups did not differ in adverse events. Conclusions: Among moderately preterm neonates, weaning from incubator to crib at a lower weight did not decrease length of stay, but was safe and was accompanied by higher weight gain after weaning. Trial Registration: ClinicalTrials.gov NCT02160002.",
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T2 - A Randomized Clinical Trial

AU - Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network

AU - Shankaran, Seetha

AU - Bell, Edward F.

AU - Laptook, Abbot R.

AU - Saha, Shampa

AU - Newman, Nancy S.

AU - Kazzi, S. Nadya J.

AU - Barks, John

AU - Stoll, Barbara J.

AU - Bara, Rebecca

AU - Gabrio, Jenna

AU - Childs, Kirsten

AU - Das, Abhik

AU - Higgins, Rosemary D.

AU - Carlo, Waldemar A.

AU - Sánchez, Pablo J.

AU - Carlton, David P.

AU - Pavageau, Lara

AU - Malcolm, William F.

AU - D'Angio, Carl T.

AU - Ohls, Robin K.

AU - Poindexter, Brenda B.

AU - Sokol, Gregory M.

AU - Van Meurs, Krisa P.

AU - Colaizy, Tarah T.

AU - Khmour, Ayman

AU - Puopolo, Karen M.

AU - Garg, Meena

AU - Walsh, Michele C.

AU - Polin, Richard A.

AU - Keszler, Martin

AU - Hensman, Angelita M.

AU - Vieira, Elisa

AU - Hibbs, Anna Marie

AU - Siner, Bonnie S.

AU - Truog, William E.

AU - Pallotto, Eugenia K.

AU - Kilbride, Howard W.

AU - Gauldin, Cheri

AU - Holmes, Anne

AU - Johnson, Kathy

AU - Schibler, Kurt

AU - Kallapur, Suhas G.

AU - Grisby, Cathy

AU - Alexander, Barbara

AU - Fischer, Estelle E.

AU - Jackson, Lenora

AU - Kirker, Kristin

AU - Jennings, Jennifer

AU - Wuertz, Sandra

AU - Lakshminrusimha, Satyanarayana

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight. Study Design: This trial was conducted in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweight <1600 g, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0°C to 1.5°C every 24 hours until 28.0°C. The infants were weaned to the crib following stable temperature at 36.5°C to 37.4°C for 8 to 12 hours. Clothing and bedcoverings were standardized. The primary outcome was length of hospital stay from birth to discharge; secondary outcomes included length of stay and growth velocity from weaning to discharge. Adverse events were monitored. Results: Of 1565 infants screened, 885 were eligible, and 366 enrolled—187 to the 1600-g and 179 to the 1800-g group. Maternal and neonatal characteristics did not differ among weight groups. Length of hospital stay was a median of 43 days in the lower and 41 days in the higher weight group (P =.12). Growth velocity from completion of weaning to discharge was higher in the lower weight group, 13.7 g/kg/day vs 12.8 g/kg/day (P =.005). Groups did not differ in adverse events. Conclusions: Among moderately preterm neonates, weaning from incubator to crib at a lower weight did not decrease length of stay, but was safe and was accompanied by higher weight gain after weaning. Trial Registration: ClinicalTrials.gov NCT02160002.

AB - Objective: To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight. Study Design: This trial was conducted in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweight <1600 g, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0°C to 1.5°C every 24 hours until 28.0°C. The infants were weaned to the crib following stable temperature at 36.5°C to 37.4°C for 8 to 12 hours. Clothing and bedcoverings were standardized. The primary outcome was length of hospital stay from birth to discharge; secondary outcomes included length of stay and growth velocity from weaning to discharge. Adverse events were monitored. Results: Of 1565 infants screened, 885 were eligible, and 366 enrolled—187 to the 1600-g and 179 to the 1800-g group. Maternal and neonatal characteristics did not differ among weight groups. Length of hospital stay was a median of 43 days in the lower and 41 days in the higher weight group (P =.12). Growth velocity from completion of weaning to discharge was higher in the lower weight group, 13.7 g/kg/day vs 12.8 g/kg/day (P =.005). Groups did not differ in adverse events. Conclusions: Among moderately preterm neonates, weaning from incubator to crib at a lower weight did not decrease length of stay, but was safe and was accompanied by higher weight gain after weaning. Trial Registration: ClinicalTrials.gov NCT02160002.

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KW - moderately preterm infants

KW - randomized controlled trial

KW - temperature

KW - weaning

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