The Effect of Active Warming Devices on Perioperative Hypothermia in Cesarean Section Patients: A Meta-Analysis

Background: Perioperative hypothermia and shivering are common in patients undergoing cesarean section; however, the effectiveness of active warming (AW) compared to passive warming (PW) in preventing perioperative outcomes for pregnant females and their offspring remains controversial. Methods: A search was performed for randomized controlled trials (RCTs) on the impact of AW devices on perioperative hypothermia in mothers undergoing cesarean section in the Cochrane Library, PubMed, Embase, and Web of Science databases (inception–October 2024). Two researchers independently screened studies and performed a meta-analysis using Review Manager 5.4. Results: A total of 12 articles were included, encompassing 1184 patients. The meta-analysis results indicated that AW devices can mitigate the decrease in core body temperature in cesarean section mothers postoperatively (mean difference [MD] = 0.26, 95% confidence interval [CI]: (0.10, 0.43); p = 0.002), reduce the incidence of hypothermia (relative risk [RR] = 0.69, 95% CI: (0.60, 0.80); p < 0.00001), and decrease the occurrence of shivering (RR = 0.54, 95% CI: (0.40, 0.74); p = 0.0001. Conclusions: This meta-analysis demonstrates that AW devices effectively mitigate perioperative hypothermia in patients undergoing cesarean section, reducing hypothermia and shivering incidence and improving temperature management. Registration: The study has been registered on https://www.crd.york.ac.uk/prospero/ (registration number: CRD42024592013; registration link: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024592013).