Preventing hypothermia in preterm newborns - simple principles for a complicated task.

Hypothermia is a major contributor to newborn mortality worldwide and remains a common problem for very low birthweight (VLBW) infants, even in technologically advanced hospital settings. The attributable risk of mortality from hypothermia is difficult to establish from the scant randomized trials on delivery room stabilization of VLBW newborns, but the relationship between admission temperature and neonatal morbidities is U-shaped, suggesting that both hypothermia and hyperthermia are undesirable. Consequently, the recommended goal for postnatal stabilization is to maintain a normothermic temperature between 36.5 and 37.5 C. In the past decade, several reports have documented success in decreasing hypothermia rates at neonatal intensive care unit (NICU) admission, although high rates of hyperthermia were concomitantly induced in some studies. In this issue of Jornal de Pediatria, Caldas et al. report the results of a quality improvement (QI) intervention to decrease hypothermia in VLBW newborns admitted to a Brazilian NICU. They successfully reduced the hypothermia