Factors associated with hypothermia risk among patients undergoing cesarean delivery: a retrospective cohort study.

Introduction: Hypothermia can be detrimental in the perioperative period. Previous studies of hypothermia among patients after cesarean delivery (CD) have not adequately addressed a difference in hypothermia risk between general anesthesia (GA) and neuraxial anesthesia (NA).

Methods: Inclusion criteria were patients in the National Anesthesia Clinical Outcomes Registry undergoing CD. Unadjusted rates of hypothermia and odds ratios for hypothermia were determined. Continuous variables were compared using Student's t test or Mann-Whitney rank sum, as appropriate. A mixed-effects multiple logistic regression analysis was performed.

Results: There was a higher rate of hypothermia among patients undergoing CD with NA compared to GA (3.6% vs 2.4%, P = 0.001). There was a significant difference in hypothermia rates between patients from areas of different socioeconomic status (7.1% in areas of median income <$50,000 vs 2.3%, P < 0.001). A higher odds for hypothermia was associated with NA (odds ratio = 1.48; 95% confidence interval, 1.1-2), longer duration of anesthesia, and lower socioeconomic status.

Conclusion: NA was associated with a higher rate and risk for hypothermia. Patients in areas of lower socioeconomic status and those undergoing longer anesthetics were also at higher risk for hypothermia. Anesthesia providers must work to prevent and treat hypothermia in patients with these identified risk factors.