Advanced Search

CN 34-1304/RISSN 1674-3679

Volume 28 Issue 8
Aug.  2024
Turn off MathJax
Article Contents
ZHANG Peili, HU Peng, GUO Jingyi, LIN Hualiang. The impact of peak and duration of intrapartum fever on adverse perinatal maternal and neonatal outcomes[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(8): 903-908. doi: 10.16462/j.cnki.zhjbkz.2024.08.006
Citation: ZHANG Peili, HU Peng, GUO Jingyi, LIN Hualiang. The impact of peak and duration of intrapartum fever on adverse perinatal maternal and neonatal outcomes[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(8): 903-908. doi: 10.16462/j.cnki.zhjbkz.2024.08.006

The impact of peak and duration of intrapartum fever on adverse perinatal maternal and neonatal outcomes

doi: 10.16462/j.cnki.zhjbkz.2024.08.006
Funds:

National Science Foundation of Guangdong Province, China 2022A1515010420

National Natural Science Foundation of China 81972993

More Information
  • Corresponding author: LIN Hualiang, E-mail : linhualiang@mail.sysu.edu.cn
  • Received Date: 2024-01-05
  • Rev Recd Date: 2024-05-16
  • Available Online: 2024-09-29
  • Publish Date: 2024-08-10
  •   Objective  To explore the impact of maternal intrapartum fever′s peak and duration on perinatal outcomes.  Methods  This study included primiparas who delivered at term with a singleton fetus in the Shantou Central Hospital from 2020 to 2022. The exposure factor was intrapartum fever (the maternal body temperature ≥37.5 ℃). The participants were grouped based on different fever peak (Tmax, the highest recorded body temperature during labor), fever duration (t, the time from the first recorded fever to the first recorded normal body temperature or delivery), and fever composite variable v, $ \[\left[ {v = \frac{{{T_{max}} - 37℃}}{{100}} \times t} \right]\]$. The study compared the differences in neonatal outcomes (including neonatal asphyxia, neonatal infections, hypoxic-ischemic encephalopathy, seizures, intracranial hemorrhage, etc.) and adverse perinatal outcomes of pregnant women (including maternal operative delivery, postpartum hemorrhage, incision infection, puerperal sepsis). Logistic regression analysis was conducted to assess the association between the peak and duration of intrapartum fever and adverse perinatal outcomes.  Results  A total of 2 197 parturients were included in the study, and 307 (13.9%) of them had intrapartum fever. Compared with afebrile parturients, febrile parturients had higher rates of neonatal adverse outcomes and maternal operative delivery. After adjusting for confounding factors, for every 1 ℃ increase in fever peak, the risk of adverse neonatal outcomes increased by 1.204 times (OR =2.204, 95% CI: 1.691-2.423), and the risk of maternal operative delivery increased by 88.3% (OR =1.883, 95% CI: 1.581-2.242);for every 60-minute increase in the duration of fever, the risk of adverse neonatal outcomes increased by 28.4% (OR =1.284, 95% CI: 1.178-1.400), and the risk of maternal operative delivery increased by 29.4% (OR =1.294, 95% CI: 1.183-1.414);for every 1 unit increase in the composite variable of fever, the risk of adverse neonatal outcomes increased by 55.4% (OR =1.554, 95% CI: 1.359-1.777), and the risk of maternal operative delivery increased by 49.4% (OR =1.494, 95% CI: 1.298-1.720).  Conclusions  Increased peak fever, increased duration of fever, and increased composite fever variables were associated with higher risk of adverse neonatal outcomes and maternal operative delivery.
  • loading
  • [1]
    Goetzl L. Maternal fever in labor: etiologies, consequences, and clinical management[J]. Am J Obstet Gynecol, 2023, 228(5S): S1274-S1282. DOI: 10.1016/j.ajog.2022.11.002.
    [2]
    Ashwal E, Salman L, Tzur Y, et al. Intrapartum fever and the risk for perinatal complications - the effect of fever duration and positive cultures[J]. J Matern Fetal Neonatal Med, 2018, 31(11): 1418-1425. DOI: 10.1080/14767058.2017.1317740.
    [3]
    Greenwell EA, Wyshak G, Ringer SA, et al. Intrapartum temperature elevation, epidural use, and adverse outcome in term infants[J]. Pediatrics, 2012, 129(2): e447-e454. DOI: 10.1542/peds.2010-2301.
    [4]
    Kim SY, Hong SY, Kwon DY, et al. Degree of intrapartum fever and associated factors: Three Group analysis of no fever, borderline and overt fever[J]. J Obstet Gynaecol Res, 2021, 47(3): 1153-1163. DOI: 10.1111/jog.14651.
    [5]
    An HM, Zheng W, Zhu QH, et al. Retrospective study of intrapartum fever in term pregnancies and adverse obstetric and neonatal outcomes[J]. PeerJ, 2022, 10: e14242. DOI: 10.7717/peerj.14242.
    [6]
    Dior UP, Kogan L, Eventov-Friedman S, et al. Very high intrapartum fever in term pregnancies and adverse obstetric and neonatal outcomes[J]. Neonatology, 2016, 109(1): 62-68. DOI: 10.1159/000440938.
    [7]
    National Institute for Health and Care Excellence. Intrapartum care[EB/OL]. London: National Institute for Health and Care Excellence (NICE); (2023-09-29)[2023-12-31]. https://www.nice.org.uk/guidance/ng235
    [8]
    Hochler H, Lipschuetz M, Guedalia J, et al. The impact of peak and duration of maternal intrapartum fever on perinatal outcomes[J]. Am J Obstet Gynecol MFM, 2021, 3(4): 100390. DOI: 10.1016/j.ajogmf.2021.100390.
    [9]
    Yager J, Towfighi J, Vannucci RC. Influence of mild hypothermia on hypoxic-ischemic brain damage in the immature rat[J]. Pediatr Res, 1993, 34(4): 525-529. DOI: 10.1203/00006450-199310000-00029.
    [10]
    Wass CT, Lanier WL, Hofer RE, et al. Temperature changes of > or = 1 degree C alter functional neurologic outcome and histopathology in a canine model of complete cerebral ischemia[J]. Anesthesiology, 1995, 83(2): 325-335. DOI: 10.1097/00000542-199508000-00013.
    [11]
    Patel S, Ciechanowicz S, Blumenfeld YJ, et al. Epidural-related maternal fever: incidence, pathophysiology, outcomes, and management[J]. Am J Obstet Gynecol, 2023, 228(5S): S1283-S1304. e1. DOI: 10.1016/j.ajog.2022.06.026.
    [12]
    Walter EJ, Hanna-Jumma S, Carraretto M, et al. The pathophysiological basis and consequences of fever[J]. Crit Care, 2016, 20(1): 200. DOI: 10.1186/s13054-016-1375-5.
    [13]
    Lagodka S, Petrucci S, Moretti ML, et al. Fetal and maternal inflammatory response in the setting of maternal intrapartum fever with and without clinical and histologic chorioamnionitis[J]. Am J Obstet Gynecol MFM, 2022, 4(2): 100539. DOI: 10.1016/j.ajogmf.2021.100539.
    [14]
    Hensel D, Zhang F, Carter EB, et al. Severity of intrapartum fever and neonatal outcomes[J]. Am J Obstet Gynecol. 2022;227(3): 513.e1-513.e8. DOI: 10.1016/j.ajog.2022.05.031.
    [15]
    Smulian JC, Bhandari V, Vintzileos AM, et al. Intrapartum fever at term: serum and histologic markers of inflammation[J]. Am J Obstet Gynecol, 2003, 188(1): 269-274. DOI: 10.1067/mob.2003.11.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(4)

    Article Metrics

    Article views (116) PDF downloads(16) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return