Eran Ashwal1,2, Lina Salman1,2, Yossi Tzur2,3, Amir Aviram2,3, Tali Ben-Mayor Bashi2, Yariv Yogev2,3, Liran Hiersch2,3. 1. a Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel. 2. b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel. 3. c Lis Maternity and Women's Hospital , Tel-Aviv Sourasky Medical Center , Tel Aviv , Israel.
Abstract
OBJECTIVE: To estimate the association between intrapartum fever and adverse perinatal outcome. METHODS: A retrospective cohort study of women attempting vaginal delivery at term in a tertiary hospital (2012-2015). Perinatal outcome of deliveries complicated by intrapartum fever (≥38.0 °C) were compared to women with no intrapartum fever matched by parity and gestational age at delivery in a 1:2 ratio. Maternal outcome included cesarean section (CS), operative vaginal delivery (OVD), retained placenta or post-partum hemorrhage. Neonatal outcome included 5-minute Apgar score <7, umbilical artery pH <7.1, meconium aspiration syndrome, need for mechanical ventilation or hypoxic ischemic encephalopathy. RESULTS: Overall, 309 women had intrapartum fever and 618 served as controls. Women with intrapartum fever had higher rates of OVD (34.3 versus 19.6%, p < .001) and CS (20.7 versus 8.7%, p < .001). In multivariate analysis, intrapartum fever was independently associated with adverse maternal (3.75, 95%CI 2.65-5.30, p < .001) and neonatal outcome (3.39, 95%CI 1.78-6.45, p < .001). In febrile women, fever duration was related to maternal complications, specifically to CS. In addition, maternal bacteremia and positive placental cultures were risk factors for neonatal complications compared to those with negative cultures (23.3 versus 9.8%, p = .01). CONCLUSIONS: Intrapartum fever was associated with adverse perinatal complications. The duration of intrapartum fever, maternal bacteremia, and positive cultures further increase this risk.
OBJECTIVE: To estimate the association between intrapartum fever and adverse perinatal outcome. METHODS: A retrospective cohort study of women attempting vaginal delivery at term in a tertiary hospital (2012-2015). Perinatal outcome of deliveries complicated by intrapartum fever (≥38.0 °C) were compared to women with no intrapartum fever matched by parity and gestational age at delivery in a 1:2 ratio. Maternal outcome included cesarean section (CS), operative vaginal delivery (OVD), retained placenta or post-partum hemorrhage. Neonatal outcome included 5-minute Apgar score <7, umbilical artery pH <7.1, meconium aspiration syndrome, need for mechanical ventilation or hypoxic ischemicencephalopathy. RESULTS: Overall, 309 women had intrapartum fever and 618 served as controls. Women with intrapartum fever had higher rates of OVD (34.3 versus 19.6%, p < .001) and CS (20.7 versus 8.7%, p < .001). In multivariate analysis, intrapartum fever was independently associated with adverse maternal (3.75, 95%CI 2.65-5.30, p < .001) and neonatal outcome (3.39, 95%CI 1.78-6.45, p < .001). In febrile women, fever duration was related to maternal complications, specifically to CS. In addition, maternal bacteremia and positive placental cultures were risk factors for neonatal complications compared to those with negative cultures (23.3 versus 9.8%, p = .01). CONCLUSIONS:Intrapartum fever was associated with adverse perinatal complications. The duration of intrapartum fever, maternal bacteremia, and positive cultures further increase this risk.
Authors: Gareth L Ackland; Stefan Van Duijvenboden; Tom E F Abbott; Ana Gutierrez Del Arroyo; Matthew J Wilson; Anna L David Journal: Br J Anaesth Date: 2021-11-19 Impact factor: 9.166
Authors: Antonina I Frolova; Molly J Stout; Ebony B Carter; George A Macones; Alison G Cahill; Nandini Raghuraman Journal: Am J Obstet Gynecol MFM Date: 2020-11-27