Delaying First Bathing and Skin Barrier Function on Infant
Condition: Premature; Thermoregulation
MeSH terms: Premature Birth
Study type: Interventional

Summary: 
      It is still unknown when the first bath should be done in premature newborns. Investigators
      think that delaying the time of the first bath compared to the time in the clinic will show
      some positive changes in preterm newborns.
    

Detailed description: 
      Bath procedures and timing to reduce neonatal stress and protect the skin barrier should be
      preferred. This study aims to investigate the effect of delaying the first bath on skin
      barrier function, comfort and body temperature in late preterm infants. The study, between
      March 2020 and March 2021 in Turkey / Antalya will be held in three central provinces in the
      Neonatal Intensive Care Unit. Skincare is routinely performed between 08.00 and 09.00 in the
      form of a tub bath. This study sampled 80 stable, late preterm infants who were cared for in
      the NICU. This example was considered to be sufficient based on a sample size calculation in
      PS Power and Sample Size Calculations (Version 3.0). Allocations about the allocation were
      provided only by the lead researcher. Participants were given a sequential number placed in
      an opaque, closed envelope by the researcher who received the signed parental informed
      consent. When the participant is planned to take a bath, the researcher will be blind. The
      researcher who will apply the bathing process will not know the postnatal age of the baby
      when bathing. And the outcome evaluation of the participants was blinded. The participants
      were randomly divided into two groups. The bath will be applied to one group within the first
      48 hours and the other group within 48-72 hours. The participants will then be placed in a
      preheated incubator that varies according to the weight and age of the participant. To
      compensate for such differences, the heads of all participants will be placed at a height of
      30 degrees in the right lateral position after bathing. After the bath, participants were
      left without intervention or contact for about 10 minutes or until they settled before being
      evaluated. The participant Baths Work Record, a data collection tool, was designed
      specifically for this study. The instrument includes a series of scales for measuring outcome
      variables and demographic information (age, sex, mode of delivery, gestational age, birth
      weight, bodyweight at work, etc.). Outcome measurements include transepidermal water loss for
      skin barrier function, neonatal comfort behavior, and body temperature. Those responsible for
      data collection will be blinded in the allocation of the participants they evaluate. The
      ComfortNeo scale will be used to measure the comfort and pain intensity of newborns. The
      outcome criteria will be evaluated in three separate cases (10 minutes before bath, 1 minute
      and 10 minutes after bath). SPSS 20.0 and SAS (ver. 9.3) will be used and statistical
      significance will be set to p <0.05.

      The data will be presented as means and standard deviations for continuous variables and as
      frequencies for categorical variables. For participant characteristics such as birth type and
      gender, the chi-square test will be used to determine whether there is a significant
      difference between the groups. Participant characteristics such as birth weight and body
      weight during the study will be evaluated for significant intergroup differences using a
      one-way ANOVA test. In order to compare different phases, the measurement parameters (comfort
      score, body temperature) in the baths will be averaged separately. To analyze both
      intra-group and intra-group differences, repeated variance analysis followed by Bonferroni's
      post hoc test.
    

Intervention name(s): Bathing
Intervention type(s): Procedure
Intervention description(s): Traditionally, it is the process of washing the newborn in the first hours of life to remove blood, meconium, varnish and other infectious substances.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled multicenter double blind trial
Masking: Double (Care Provider, Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: First Bathing; TEWL; Neonatal intensive care unit; Nursing care; Premature infant; Skin care; Comfort