Very High Intrapartum Fever in Term Pregnancies and Adverse Obstetric and Neonatal Outcomes.
Dior Uri P,Kogan Liron,Eventov-Friedman Smadar,Gil Moran,Bahar Raz,Ergaz Zivanit,Porat Shay,Calderon-Margalit Ronit
Neonatology
BACKGROUND:Intrapartum fever is a well-known risk factor for adverse perinatal outcomes. Maternal intrapartum fever ≥39.0°C at term is a rare event during labor, and there is scarce evidence regarding its implications. OBJECTIVES:To investigate the association between very high intrapartum maternal fever and perinatal outcomes in term pregnancies. METHODS:A retrospective cohort analysis including 43,560 term, singleton live births in two medical centers between the years 2003 and 2011 was performed. We compared parturients who experienced a maximal intrapartum fever of <38.0°C with two subgroups of parturients who experienced respective maximal fevers of 38.0-38.9°C and ≥39°C. Adjusted risks for adverse perinatal outcomes were calculated by using multiple logistic regression models to control for confounders. RESULTS:Compared with normal intrapartum temperature, intrapartum fever ≥39.0°C was associated with an extremely elevated risk for neonatal sepsis 16.08 (95% CI: 2.15, 120.3) as well as with low Apgar scores and neonatal intensive care unit admissions (p < 0.001). Additionally, very high intrapartum fever was related to significantly higher risk for operative delivery (p < 0.001). CONCLUSIONS:Extremely elevated intrapartum fever is an important indicator of severe neonatal morbidity and operative delivery.
10.1159/000440938
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