Abstract
Proficiency in the care of the preterm neonate is paramount to ensuring safe and quality
outcomes. Here we review several simple interventions combined with supportive and
informative monitoring that assists the care team in facilitating this critical transitional
phase of the care of the preterm newborn. We will discuss the use of checklists, avoidance
of early cord clamping, resuscitation during delayed cord clamping, early administration
of caffeine soon after birth, and the use of additional monitoring (electrocardiogram,
carbon dioxide and respiratory function) during resuscitation. This narrative review
of the literature explores the current evidence and recommendations for optimal transition
of the preterm infant starting in the delivery room. Team communication can be optimized
by implementing the use of checklists and pre/postbriefs in the delivery room. Early
use of caffeine in preterm infants may improve systemic blood flow and blood pressure.
Delayed cord clamping and cord milking provide significant benefits when compared
with immediate cord clamping. Optimizing transition at birth is one of the critical
aspects of ensuring a good outcome for this vulnerable population.
Keywords
neonatal - resuscitation - placental transfusion - delivery room - low birth weight
