Effectiveness of a simple heated water-filled mattress for the prevention and treatment of neonatal hypothermia in the labour room

NY Boo, S Selvarani
Correspondence: Professor Nem Yun Boo, nyboo@imu.edu.my

ABSTRACT
Introduction This study aimed to determine the proportions of normothermic infants who remained normothermic, and hypothermic infants who became normothermic following the use of a heated water-filled mattress (HWM) in the labour room.
Methods A prospective observational study carried out in the labour room over a 2.5 month period on 228 well term infants delivered by lower segment caesarean section (LSCS) in the operating theatre (environmental temperature 18 degrees Celsius). Upon arrival in the labour room, the infants were placed on a HWM in a nursing cot. The axillary temperature was measured using a mercury thermometer for three minutes. Each infant was then wrapped with a large piece of linen, and covered with a blanket. Just before transfer to postnatal wards, the axillary temperature was re-measured.
Results 52.2 percent (119/228) of infants were hypothermic (temperature less than 36.5 degrees Celsius) upon arrival in the labour room. Before leaving the labour room, the median increase in axillary temperature of the initially hypothermic infants was significantly higher (0.2 degrees Celsius, interquartile range 0.5) than those initially normothermic infants (0.0 degrees Celsius, interquartile range 0.3) (p-value is less than 0.00001). Among the initially hypothermic infants, 40.3 percent (48/119) became normothermic before transfer to postnatal wards. The significant independent risk factors associated with persistent hypothermia were lower birthweight (p-value equals 0.02), lower gestational age (p-value equals 0.02) and shorter duration on the warming mattress (p-value equals 0.08). Among 109 initially normothermic infants, 17.4 percent became mildly hypothermic (mean axillary temperature 36.2 degrees Celsius, standard deviation 0.2) before leaving the labour room.
Conclusion The HWM is a reasonably effective simple device for the prevention and treatment of hypothermia in the labour room.

Keywords: heated water-filled mattress, labour room, neonatal disorders, neonatal hypothermia
Singapore Med J 2005; 46(8): 387-391