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Neutral thermal environment: advantages

Neutral thermal environments (34-35°C or 93.2-95°F) are generally recommended in the context of neonatal resuscitation. (Source 1)

There are four basic mechanisms through which heat is transferred from the newborn to the environment: radiation, conduction, convection and evaporation. (Ref. 1) Nonshivering thermogenesis is the main mechanism of heat production in neonates. A newborn infant left unattended in a room at room temperature experiences energy losses of approximately 150 kcal per min. (Ref. 1)

Effects of Hypothermia on the neonate include: (Source 2)

  • Pulmonary vasoconstriction
  • Right to left shunt
  • Hypoxemia secondary to increased oxygen consumption
  • Metabolic acidosis
  • Hypoglycemia

Suggested delivery room temperatures by age and weight: (Ref. 2)

  • Estimated gestational age (EGA) less than 26 weeks, estimated birth weight (EBW) less than 750 g, or both: 76°F or higher, target 78-80°F
  • EGA 27-28 weeks, EBW less than 1000 g, or both: 74°F or higher, target 78-80°F
  • EGA 29-32 weeks, EBW 1001-1500 g, or both: 72°F, target 75°F
  • EGA 33-36 weeks, EBW 1501-2500 g, or both: 72°F, target 75°F
  • EGA 27-42 weeks, EBW greater than 2500 g, or both: 70°F, target 75°F

In most delivery rooms, radiant heat is also delivered by open air warmers to provide the most neutral thermal environment (93.2-95°F).


  1. R F Soll Heat loss prevention in neonates. J Perinatol: 2008, 28 Suppl 1;S57-9 Link
  2. D R Bhatt, R White, G Martin, L J Van Marter, N Finer, J P Goldsmith, C Ramos, S Kukreja, R Ramanathan Transitional hypothermia in preterm newborns. J Perinatol: 2007, 27 Suppl 2;S45-7 Link