Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trials
Abstract Background Perioperative hypothermia and shivering commonly occur in pregnant women undergoing cesarean section. The warming method is usually used to prevent hypothermia and shivering. However, the effect of active warming (AW) prior to passive warming (PW) on the perioperative outcomes of...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-09-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-05054-7 |
| _version_ | 1811208636556378112 |
|---|---|
| author | Qing Zhuo Jia-Bin Xu Jing Zhang Bin Ji |
| author_facet | Qing Zhuo Jia-Bin Xu Jing Zhang Bin Ji |
| author_sort | Qing Zhuo |
| collection | DOAJ |
| description | Abstract Background Perioperative hypothermia and shivering commonly occur in pregnant women undergoing cesarean section. The warming method is usually used to prevent hypothermia and shivering. However, the effect of active warming (AW) prior to passive warming (PW) on the perioperative outcomes of pregnant women and their offspring remains controversial. Methods This study aimed to investigate the effects of AW and PW on maternal and newborn perioperative outcomes during cesarean delivery. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PubMed, Embase, Scopus, and the Cochrane Library were used to search for randomized controlled trials (RCTs) up to August 7, 2022. The Cochrane risk of bias assessment tool was used to assess articles selected for the systematic review. Continuous data were analyzed using weighted mean differences (WMDs) with 95% confidence intervals (CIs), and categorical data were analyzed by the random-effects model. Results A total of 1241 participants from twelve RCTs were selected for the final meta-analysis. AW was associated with a lower risk of maternal hypothermia (RR: 0.77, 95% CI: 0.63–0.93, P = 0.007) and shivering (RR: 0.56, 95% CI: 0.37–0.85; P = 0.007). AW was associated with high maternal temperature (WMD: 0.27, 95%CI: 0.14 to 0.40, P < 0.001). No significant difference was observed between AW and PW in terms of hypothermia (RR: 0.60, 95% CI: 0.24–1.51, P = 0.278), temperature (WMD: 0.31, 95% CI: − 0.00 to 0.62; P = 0.050), and umbilical vein PH in newborns (WMD: -0.00; 95% CI: − 0.02 to 0.02, P = 0.710). Conclusions These findings suggested that AW can better prevent maternal hypothermia and shivering than PW. In contrast, no significant effect was observed in newborns. Overall, the quality of the included studies is high due to RCTs, low risk of bias, consistency, and precision. We identified the quality of the overall evidence from the survey to be GRADE I. |
| first_indexed | 2024-04-12T04:24:55Z |
| format | Article |
| id | doaj.art-cb1c92e1bbf84cabafe614268d98a54a |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-12T04:24:55Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-cb1c92e1bbf84cabafe614268d98a54a2022-12-22T03:48:06ZengBMCBMC Pregnancy and Childbirth1471-23932022-09-0122111010.1186/s12884-022-05054-7Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trialsQing Zhuo0Jia-Bin Xu1Jing Zhang2Bin Ji3Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical UniversityFujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical UniversityFujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical UniversityShanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong UniversityAbstract Background Perioperative hypothermia and shivering commonly occur in pregnant women undergoing cesarean section. The warming method is usually used to prevent hypothermia and shivering. However, the effect of active warming (AW) prior to passive warming (PW) on the perioperative outcomes of pregnant women and their offspring remains controversial. Methods This study aimed to investigate the effects of AW and PW on maternal and newborn perioperative outcomes during cesarean delivery. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PubMed, Embase, Scopus, and the Cochrane Library were used to search for randomized controlled trials (RCTs) up to August 7, 2022. The Cochrane risk of bias assessment tool was used to assess articles selected for the systematic review. Continuous data were analyzed using weighted mean differences (WMDs) with 95% confidence intervals (CIs), and categorical data were analyzed by the random-effects model. Results A total of 1241 participants from twelve RCTs were selected for the final meta-analysis. AW was associated with a lower risk of maternal hypothermia (RR: 0.77, 95% CI: 0.63–0.93, P = 0.007) and shivering (RR: 0.56, 95% CI: 0.37–0.85; P = 0.007). AW was associated with high maternal temperature (WMD: 0.27, 95%CI: 0.14 to 0.40, P < 0.001). No significant difference was observed between AW and PW in terms of hypothermia (RR: 0.60, 95% CI: 0.24–1.51, P = 0.278), temperature (WMD: 0.31, 95% CI: − 0.00 to 0.62; P = 0.050), and umbilical vein PH in newborns (WMD: -0.00; 95% CI: − 0.02 to 0.02, P = 0.710). Conclusions These findings suggested that AW can better prevent maternal hypothermia and shivering than PW. In contrast, no significant effect was observed in newborns. Overall, the quality of the included studies is high due to RCTs, low risk of bias, consistency, and precision. We identified the quality of the overall evidence from the survey to be GRADE I.https://doi.org/10.1186/s12884-022-05054-7Active warmingPassive warmingHypothermiaShiveringCesarean delivery |
| spellingShingle | Qing Zhuo Jia-Bin Xu Jing Zhang Bin Ji Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trials BMC Pregnancy and Childbirth Active warming Passive warming Hypothermia Shivering Cesarean delivery |
| title | Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trials |
| title_full | Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trials |
| title_short | Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trials |
| title_sort | effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery a systematic review and meta analysis of randomized controlled trials |
| topic | Active warming Passive warming Hypothermia Shivering Cesarean delivery |
| url | https://doi.org/10.1186/s12884-022-05054-7 |
| work_keys_str_mv | AT qingzhuo effectofactiveandpassivewarmingonpreventinghypothermiaandshiveringduringcesareandeliveryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT jiabinxu effectofactiveandpassivewarmingonpreventinghypothermiaandshiveringduringcesareandeliveryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT jingzhang effectofactiveandpassivewarmingonpreventinghypothermiaandshiveringduringcesareandeliveryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT binji effectofactiveandpassivewarmingonpreventinghypothermiaandshiveringduringcesareandeliveryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials |