MEDLINE Journals

    Intrapartum maternal fever and neonatal outcome.

    Authors
    Lieberman E, Lang J, Richardson DK, et al. 
    Source
    Pediatrics 2000 Jan; 105(1 Pt 1) :8-13.
    Abstract

    Much of fever during term labor may not be infectious but rather a consequence of the use of epidural analgesia. Therefore, we investigated the association of elevated maternal intrapartum temperature with neonatal outcome when the infant does not develop an infection.We studied 1218 nulliparous women with singleton, term pregnancies in a vertex presentation and spontaneous labor. Women were excluded if their temperature was >99.5 degrees F at admission for delivery, if they were diabetic or had an active genital herpes infection or if their infant developed a neonatal infection, had a congenital infection, or had a major malformation. Maximum intrapartum temperature was categorized as: </=100.4 degrees F (afebrile), 100.5 degrees F to 101 degrees F, and >101 degrees F.During labor, 123 women (10.1%) developed a fever >100.4 degrees F; 62 (5.1%) women had a maximum temperature of 100.5 degrees F to 101 degrees F and 61 (5.0%) women had a maximum temperature >101 degrees F. Of febrile women, 97.6% had received epidural analgesia for pain relief. Infants of women developing a fever >100.4 degrees F were more likely to have a 1-minute Apgar score <7 (22.8% for >100.4 degrees F vs 8.0% for afebrile) and to be hypotonic after delivery (4.8% for >100.4 degrees F vs.5% for afebrile). Compared with infants of afebrile women, infants whose mothers' maximum temperature was >101 degrees F were more likely to require bag and mask resuscitation (11.5% vs 3.0%) and to be given oxygen therapy in the nursery (8.2% vs 1.3%). We also found a higher rate of neonatal seizure with fever (3.3% vs.2%), but the number of infants with seizure was small (n = 4). All associations remained essentially the same after controlling for confounding in logistic regression analyses.Intrapartum maternal fever, particularly if >101 degrees F, was associated with a number of apparently transient adverse effects in the newborn. Larger studies are needed to investigate the association of intrapartum fever with neonatal seizures and to determine whether any lasting injury to the fetus may occur.

    Mesh
    Adult
    Analgesia, Epidural
    Analgesia, Obstetrical
    Apgar Score
    Female
    Fever
    Humans
    Infant, Newborn
    Infant, Newborn, Diseases
    Obstetric Labor Complications
    Oxygen Inhalation Therapy
    Pregnancy
    Pregnancy Outcome
    Respiration, Artificial
    Language

    eng

    Pub Type(s)
    Clinical Trial Journal Article Randomized Controlled Trial Research Support, U.S. Gov't, P.H.S.
    PubMed ID

    10617697

    Content Manager
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