TY - JOUR
T1 - Intrapartum fever and the risk for perinatal complications–the effect of fever duration and positive cultures
AU - Ashwal, Eran
AU - Salman, Lina
AU - Tzur, Yossi
AU - Aviram, Amir
AU - Ben-Mayor Bashi, Tali
AU - Yogev, Yariv
AU - Hiersch, Liran
N1 - Publisher Copyright:
© 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/6/3
Y1 - 2018/6/3
N2 - 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.
AB - 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.
KW - Adverse outcome
KW - culture
KW - intrapartum fever
KW - neonatal outcome
UR - http://www.scopus.com/inward/record.url?scp=85018843856&partnerID=8YFLogxK
U2 - 10.1080/14767058.2017.1317740
DO - 10.1080/14767058.2017.1317740
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C2 - 28391772
AN - SCOPUS:85018843856
SN - 1476-7058
VL - 31
SP - 1418
EP - 1425
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 11
ER -