Managing preterm infants in the first minutes of life.

Premature infants often experience difficulties adapting to postnatal life. The most relevant ones are related to establishing an adult type cardiorespiratory circulation and acquiring hemodynamic stability, aerating the lung and attaining a functional residual capacity, performing an adequate gas exchange and switching to an oxygen enriched metabolism, and keeping an adequate body temperature. In recent years a body of evidence supports a trend towards gentle management in the delivery room aiming to reduce damage especially to the lungs in the so-called first golden minutes. Herewith, we describe and update four of the most relevant interventions performed in the delivery room: delayed cord clamping, non-invasive ventilation, individualized oxygen supplementation, and maintaining an adequate body temperature so as to avoid hyperthermia and/or hypothermia.