Premium
Degree of intrapartum fever and associated factors: Three group analysis of no fever, borderline and overt fever
Author(s) -
Kim SeoYeon,
Hong SirYeon,
Kwon Do Youn,
Park Hyea,
Choi SukJoo,
Oh SooYoung,
Kim JungSun,
Choi Duck Hwan,
Roh CheongRae
Publication year - 2021
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14651
Subject(s) - medicine , chorioamnionitis , odds ratio , sepsis , obstetrics , incidence (geometry) , pregnancy , postoperative fever , neonatal sepsis , confidence interval , multivariate analysis , fetus , pediatrics , genetics , physics , percutaneous , optics , biology
Aim Previous studies analyzing intrapartum fever by dichotomization of fever just above 38.0°C or not may lead to overlook clinical significance of borderline fever. We aimed to investigate the maternal baseline and intrapartum characteristics, neonatal outcomes, and inflammatory placental pathology in relation to the degree of intrapartum fever by three group analysis. Methods We performed a retrospective analysis of consecutive singleton deliveries between 37 0/7 to 41 0/7 weeks divided into three groups based on the peak body temperature during labor: No fever (< 37.5°C), borderline fever (≥ 37.5°C and < 38.0°C), and overt fever (≥ 38.0°C). Maternal and intrapartum characteristics, neonatal outcomes, and inflammatory placental pathology were compared by trend analysis, intergroup difference analysis, and multivariable analysis. Results The degree of intrapartum fever was significantly associated with younger maternal age, nulliparity, longer duration of rupture of membrane, and epidural analgesia ( p < 0.001). And the incidence of neonatal proven sepsis and mortality were not significantly different among the groups. The degree of intrapartum fever was associated with the stage of acute chorioamnionitis and funisitis ( p < 0.001). Multivariate analysis revealed that the association with epidural analgesia was stronger in borderline fever than overt fever (adjusted odds ratio [95% confidence interval], borderline fever = 18.487 [11.447–29.857]; overt fever = 11.068 [4.874–25.133]) after controlling for maternal age, parity, induction or augmentation, duration of ROM, birth weight, and meconium staining. Conclusion Our data support that both epidural analgesia and inflammation of the placenta may contribute to the development of intrapartum fever at term.