Conductive thermal mattress versus routine care to reduce neonatal hypothermia during transport among low-birthweight neonates: An experimental study with historical controls

Abstract Background Neonatal hypothermia at delivery, during transport and in the postnatal wards is common, under-recognized and infrequently monitored with prevalence ranging from 32% to 85%. This study compared conductive thermal mattress to routine care for prevention of hypothermia among low-birthweight (LBW) neonates during transport. Methods From July 2015 to November 2016 (historical controls), all eligible LBW neonates (1500–2499 g) were transported from the labour room/operation theatre to the neonatal intensive care unit (NICU)/postnatal wards using routine care (towels, blankets, cap, mittens and socks) and from December 2016 to December 2018 using conductive thermal mattress (EMBRACETM) Axillary temperature was measured before transport and at arrival in the NICU/postnatal wards using a digital thermometer. Results A total of 154 and 102 neonates were transported using conductive thermal mattress and routine care, respectively. The mean standard deviation (SD) axillary temperature at arrival in the postnatal wards in conductive thermal mattress and routine care group was 36.6 (0.6) ⁰C and 36.4 (0.5) ⁰C, respectively (p-value 0.005). Relative Risk (RR) of mild and moderate neonatal hypothermia among neonates transported using conductive thermal mattress compared to routine care group was 0.59 (0.33,1.07), number needed to treat (NNT) of 13 and 0.22 (0.04,1.07), NNT 22 respectively. Conclusions Use of conductive thermal mattress for transport among LBW neonates led to a significant, although clinically small improvement in admission temperatures at the NICU/postnatal ward and non-significant decrease in the incidence of hypothermia.