Risk Factors for Intrapartum Fever in Term Gestations and Associated Maternal and Neonatal Sequelae

Abstract

Aim: To determine factors associated with intrapartum fever and to examine associated maternal and neonatal outcomes.

Methods: Retrospective study of patients between 360/7 and 420/7 gestational weeks who entered spontaneous or induced active labor and developed temperature ≥38°C; a similar group that did not develop fever were controls. Univariate and multivariate analyses were performed with p < 0.05 as significant.

Results: Fifty-four febrile patients and 306 nonfebrile controls met inclusion criteria. Nulligravidity (45.8 vs. 77.8%, p < 0.001), length of first stage ≥720 min (OR 3.59, 95% CI 1.97-6.55, p < 0.001), length of second stage ≥120 min (OR 4.76, 95% CI 2.29-9.89, p < 0.001), membrane rupture ≥240 min (46.4 vs. 79.6%, p < 0.001), increasing number of vaginal exams (4 vs. 6, p < 0.001), oxytocin (44.8 vs. 63.0%, p = 0.014), and meperidine (14.7 vs. 35.2%, p < 0.001) were all associated with intrapartum fever. Associated morbidity included cesarean delivery (22.5 vs. 44.4%, p = 0.001), Apgar score <7 at 5 min (0.7 vs. 5.6%, p = 0.011), and neonatal intensive care unit admission (9.5 vs. 51.9%, p < 0.001).

Conclusion: We have identified several noninfectious factors that are associated with intrapartum fever. Modification of risk factors may improve both maternal and neonatal outcomes.

Keywords: Acetaminophen; Cesarean section; Maternal fever; Morbidity; Noninfectious etiology; Risk factors.

Conflict of interest statement

Disclosure Statement

The authors have received no competing interests and have not received funding from any entities listed in the article, and therefore, have nothing to declare.

© 2017 S. Karger AG, Basel.