Risk Factors and Safety Analyses for Intrapartum Fever in Pregnant Women Receiving Epidural Analgesia During Labor
Jie Ren, Tao Wang, Bo Yang, Lihua Jiang, Linglan Xu, Xiaoyuan Geng, Qian Liu
Department of Anesthesiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
Med Sci Monit 2021; 27:e929283
Available online: 2021-01-08
We aimed to explore the factors leading to epidural-related maternal fever and the influence of intrapartum fever on neonates.
MATERIAL AND METHODS: A retrospective analysis was performed on data from pregnant women who received epidural analgesia during labor. The primary aim was to determine the influence of epidural labor analgesia on the incidence of intrapartum fever in pregnant women. The secondary aim was to determine the influence of intrapartum fever on neonates.
RESULTS: Logistic regression analysis showed that premature rupture of membranes (OR=2.008, 95% CI: 1.551-2.600), vaginal examination performed more than 6 times (OR=1.681, 95% CI: 1.286-2.197), long duration of labor (OR=1.090, 95% CI: 1.063-1.118), and long time from rupture of membranes to delivery (OR=1.048, 95% CI: 1.010-1.087) were all risk factors for intrapartum fever in pregnant women with epidural labor analgesia. Regarding the secondary research outcome, the incidence of intrapartum fever was significantly associated with the number of neonates with Apgar score of 10 delivered from pregnant women with epidural labor analgesia (P<0.05). There was no statistically significant difference in the transfer rate of newborns to the Neonatal Intensive Care Unit (NICU) (P>0.05).
CONCLUSIONS: Premature rupture of membranes, vaginal examination performed more than 6 times, long duration of labor, and long time from rupture of membranes to delivery are all factors raising the risk of fever during epidural labor analgesia. Although intrapartum fever in the mothers had a significant influence on the number of neonates with Apgar score of 10, it did not affect the outcome of neonates in terms of NICU transfer rate.
Keywords: Anesthesia, Caudal, Factor Analysis, Statistical, Fever, Logistic Models