Abstract
Purpose: Maintaining normothermia is a key component of optimal neonatal care, as both hypothermia and hyperthermia are associated with increased morbidity and mortality across gestational ages. This study evaluated the relationship between the use of heated cot and thermal outcome during the first postnatal days.
Methods: This multicentre retrospective comparative study included healthy neonates (N= 1371) born at ≥36 weeks gestation and weighing >2.2 kg in two maternity units using different thermoregulatory protocols: heated cot care versus standard cot care. The primary outcome was normothermia; secondary outcomes included hypothermia and hyperthermia.
Results: Heated cot use was associated with significantly more normothermia (OR 1.48, 95% CI 1.28–1.72) and less hypothermia (OR 0.51, 95% CI 0.42–0.63), but significantly more hyperthermia (OR 1.72, 95% CI 1.28–2.31). These associations were time-dependent, as demonstrated by a significant interaction between heated cot use and postnatal age for normothermia and hypothermia. In neonates small for gestational age, heated cot use was associated with both higher odds of normothermia (OR 2.0, 95% CI 1.35–2.95) and lower odds of hypothermia (OR 0.42, 95% CI 0.26–0.67). Similar non-significant trends were observed with lower birthweight and gestational age.
Conclusion: Heated cot use was associated with more normothermia and less hypothermia, but also more hyperthermia. Routine use in all healthy neonates may not be warranted, although selected high-risk neonates may benefit.