Department of Surgical Anesthesiology, The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, 410007 Changsha, Hunan, China.
Ann Ital Chir. 2024;95(4):448-460. doi: 10.62713/aic.3337.
Hypothermia is one of the common complications of cesarean section, which has a serious impact on intraoperative surgical safety and postoperative recovery of pregnant women. Mitigation of the risk factors of hypothermia in pregnant women undergoing cesarean section may reduce the probability of its occurrence and improve the perioperative comfort of pregnant women. Therefore, this study systematically evaluates the influencing factors of hypothermia in patients undergoing cesarean section, aiming to provide references for the prevention of hypothermia in pregnant women undergoing cesarean section.
A systematic search was conducted across various databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Chinese Biomedical Literature databases to gather observational studies on the factors affecting hypothermia in pregnant women undergoing cesarean section. The search deadline was January 30, 2024. Two researchers independently screened literature, extracted data, evaluated quality, and crosschecked the outcomes. Meta analysis was conducted using RevMan 5.3 and Stata17.0.
Twelve studies were included in this review, all of which were case-control studies conducted from 2014 to 2022, encompassing a total of 5561 pregnant women. The quality of the studies included was average or above. The meta-analysis results showed that body mass index (mean difference (MD) = -1.47; 95% confidence interval (CI) [-2.84, -0.11]; p = 0.03), operating room temperature (odds ratio (OR) = 2.08; 95% CI [1.56, 2.76]; p < 0.00001), anesthesia method (OR = 1.84; 95% CI [1.40, 2.42]; p < 0.0001), fluid loss (MD = 160.09; 95% CI [77.31, 242.87]; p = 0.0002), flushing volume (MD = 66.43; 95% CI [8.46, 124.40]; p = 0.02), and hypothyroidism (OR = 2.29; 95% CI [1.61, 3.27]; p < 0.00001) were risk factors for perioperative hypothermia in pregnant women undergoing cesarean section (p < 0.05).
The occurrence of hypothermia in pregnant women during the perioperative period is influenced by factors such as low body mass index, spinal anesthesia, low operating room temperature, intraoperative fluid loss, large flushing volume, and hypothyroidism.
低温是剖宫产术中常见的并发症之一，对孕妇术中手术安全和术后恢复有严重影响。降低剖宫产孕妇发生低温的风险因素，可能会降低其发生概率，提高孕妇围手术期舒适度。因此，本研究系统评价剖宫产孕妇发生低温的影响因素，旨在为预防剖宫产孕妇低温提供参考。
通过PubMed、Cochrane Library、Embase、Web of Science、中国知网（CNKI）、万方和中国生物医学文献数据库系统检索剖宫产孕妇低温影响因素的观察性研究，检索时限截至 2024 年 1 月 30 日。由 2 位研究者独立筛选文献、提取数据、评价质量、交叉核对结局。采用 RevMan 5.3 和 Stata17.0 进行 Meta 分析。
共纳入 12 项研究，均为 2014 年至 2022 年的病例对照研究，共纳入 5561 例孕妇。研究质量为中高质量。Meta 分析结果显示，体质量指数（均数差（MD）=-1.47；95%置信区间（CI）[-2.84，-0.11]；p=0.03）、手术间温度（比值比（OR）=2.08；95%CI[1.56，2.76]；p<0.00001）、麻醉方式（OR=1.84；95%CI[1.40，2.42]；p<0.0001）、液体丢失量（MD=160.09；95%CI[77.31，242.87]；p=0.0002）、冲洗量（MD=66.43；95%CI[8.46，124.40]；p=0.02）、甲状腺功能减退症（OR=2.29；95%CI[1.61，3.27]；p<0.00001）是剖宫产孕妇围术期发生低温的危险因素（p<0.05）。
孕妇围手术期发生低温与体质量指数低、椎管内麻醉、手术间温度低、术中液体丢失量多、冲洗量大、甲状腺功能减退症等因素有关。
