Perioperative active warming for preventing neonatal hypothermia: the Neohyp trial

Abstract

Background Perioperative hypothermia for women undergoing elective caesarean section is a common comorbidity, which may result in neonatal hypothermia when at-birth skin-to-skin contact is performed. This trial compared the effectiveness of warm intravenous and room temperature fluids among women performing at birth skin-to-skin contact on perioperative neonatal and maternal heat loss. Methods A double-blind, randomised controlled trial compared warm and room temperature intravenous fluids in 150 healthy women performing at birth skin-to-skin contact while undergoing elective caesarean section. Analysis was based on intention-to-treat. Results Active warming of women significantly reduced neonatal (P=0.02) and maternal (P=0.0027) hypothermia at the end of skin-to-skin contact in the operative theatre, maternal hypothermia on post-anaesthesia care unit admission (P=0.0022) and maternal shivering (P=0.0001). Conclusions Administering warm intravenous fluids during caesarean section when skin-to-skin contact is performed at birth is a safe practice with multiple health benefits for both newborns and their mothers. Consideration should be given to incorporating this intervention into clinical practice procedures promoting skin-to-skin contact in women undergoing elective caesarean section.