Supine or lateral position?
To answer this question, the Neonatal Research Group Dresden conducted a study on newborn’s position with Mangold INTERACT
Delivery room management of the newly born infant should be performed according to international guidelines, but no recommendations are available for an infant’s position immediately after birth.
A current study of the “Neonatal Research Group Dresden” at the Universitätsklinikum Dresden examines the benefits of supine and side position using videobased data analysis.
Methods
187 videos of delivery room treatments for newborns were recorded and analyzed using the Mangold INTERACT software. Videos were analyzed for infant’s position, administered interventions, vital parameters and agitation.
Results
The Main Position (defined as position spent more than 70% of the time) was “supine” in 91, “side” in 63 and “not determinable” in 33 infants. “Supine” infants received significantly more often stimulation than “side” infants. There were no differences between both groups with regard to suctioning; CPAP was exclusively (98%) administered in supine position. Newborns on side were less agitated than those on supine. There was a trend towards a better oxygenation in “side” positioned infants and significantly higher saturation values in “left-sided” infants than “right-sided” infants at 8th minute. “Side” positioned infants reached oxygen saturation values >90% earlier than “supine” positioned infants.
Discussion
DR-management is feasible in the side position in term infants. Side position seems to be associated with reduced agitation and improved oxygenation. However, it remains unclear whether this represents a causal relationship or an association. The study supports the need for a randomized controlled trial.
The study concludes that the benefits of each position must be systematically examined to give recommendations for the international guidelines. The video analysis can be a valuable tool. The Universitätsklinikum Dresden uses video analysis for delivery room management for a long time. The goal is to gather data on how delivery room care is currently done, come closer to an agreement between different standards and explore new approaches.