Randomized Trial of Occlusive Wrap for Heat Loss Prevention in Preterm Infants: Neurodevelopmental Outcome
Bibliographic record
Abstract
Abstract BACKGROUND: Heat loss in the delivery room in very preterm infants is associated with increased mortality, hypothermia and other adverse outcomes. The Heat Loss Preventions (HeLP) trial was designed to address these outcomes and resulted in a significant reduction of hypothermia but not a reduction in mortality. The HeLP follow-up trial was designed to determine whether application of occlusive wrap applied immediately after birth reduces adverse long-term neurodevelopmental outcomes at 18-24 months corrected gestational age in very preterm infants. STUDY DESIGN: The original HeLP trial was a randomized controlled trial of very preterm infants (< 28 weeks gestation) placed at birth in occlusive wrap (wrap group) or not placed in occlusive wrap (control group). The HeLP follow-up trial was the later assessment of these infants enrolled in the HeLP trial to determine the composite outcome of death or neurodevelopmental disability at 18-24 month corrected gestational age. RESULTS: There were 356 infants eligible for follow-up from the randomized controlled HeLP trial with a loss to follow-up of 116/356 (32.6%). The primary outcome occurred in 82/113 in the wrap group and 80/127 in the control group (p=0.149, Fisher’s exact). Because of the large loss to follow-up rate, this unadjusted odds ratio was 1.55 (95% confidence interval=0.90-2.69) while the adjusted odds ratio (adjusted for major predictors of the outcome) was virtually unchanged at 1.52 (95% confidence interval=0.83-2.80). Secondary outcomes in the wrap versus control group were: cerebral palsy 9/70 versus 5/87 (p=0.204, Fisher’s exact), Mental Developmental Index (MDI) < 85 (Bayley Scales) 30/53 versus 33/67 (p=0.538, Fisher’s exact), blindness at 0/68 versus 1/86 (p>0.999, Fisher’s exact) and deafness 5/70 versus 6/87 (p>0.999, Fisher’s exact). No difference was noted in prescription glasses, 7/70 in the wrap group versus 2/87 in the control group (p=0.085, Fisher’s exact). CONCLUSION: Use of polyethylene occlusive wrap after birth in very preterm infants was associated with similar death or long-term neurodevelopmental disability rate. Clinical Trials Registry: Clinicaltrials.gov NCT00607464
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.013 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".