Intrapartum fever and the risk for perinatal complications–the effect of fever duration and positive cultures

Eran Ashwal, Lina Salman, Yossi Tzur, Amir Aviram, Tali Ben-Mayor Bashi, Yariv Yogev*, Liran Hiersch

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)1418-1425
Number of pages8
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume31
Issue number11
DOIs
StatePublished - 3 Jun 2018

Keywords

  • Adverse outcome
  • culture
  • intrapartum fever
  • neonatal outcome

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