Background Neonatal hypothermia (<36.5°C) is an important risk factor for babies born before arrival at hospital (BBA). In the prehospital setting babies can become hypothermic within minutes. Paramedic temperature measurement of BBA babies is inconsistent in the UK, with temperatures recorded in only 3-10% of cases. We aimed to examine which groups of women are most likely to experience BBA and what proportion of BBA babies are hypothermic on arrival at hospital in the South West of England.

Methods Anonymised extracts from routinely collected data (hospital neonatal records) were provided by six South West NHS Hospital Trusts from a three-year period (January 2018-January 2021). Records were included if they related to a live birth (≥24 weeks) attended by paramedics. Demographic characteristics of the mothers (e.g. age, ethnicity, safeguarding status) and characteristics of the birth (e.g. gestation, temperature on admission, treatment) were analysed and presented using descriptive statistics.

Results 216 babies were conveyed to hospital by the ambulance service during the above time period. There were 32 records (15%) with no admission temperature documented. Of those with a recorded admission temperature, 35% (64/184) were hypothermic on arrival at hospital. Neonatal hypothermia on arrival at hospital was associated with the need for advanced hospital care and extended length of stay. Characteristics associated with BBA included safeguarding concerns and late booking. Mothers of hypothermic babies were less likely to have had a previous birth, and more likely to have reported a disability at their booking appointment.

Conclusions More should be done to support prehospital temperature management of BBA babies, to prevent neonatal hypothermia. Although these findings may help hospital Trusts to identify those who may be at increased chance of BBA in the South West, the study is limited by the small sample size. Further work would be needed to confirm these associations.