Fernández-Guisasola J, Delgado Arnáiz C, Rodríguez Caravaca G, Serrano Rodríguez M L, García del Valle S, Gómez-Arnau J I
Area de Anestesia, Reanimación y Cuidados Críticos, Unidad de Anestesia-Reanimación, Fundación Hospital Alcorcón, Madrid.
Rev Esp Anestesiol Reanim. 2005 Apr;52(4):217-21.
To study the relation between epidural analgesia and the development of maternal fever during labor and childbirth, and to determine the possible relation between that association and neonatal welfare and in the performance of tests to rule out sepsis in newborns.
Prospective study of all women who gave birth at Fundación Hospital Alcorcón over a period of 3 years. All the women were offered epidural analgesia based on infusion of 0.0625% bupivacaine and 2 microg x mL(-1). Data collected were age, nulliparity, epidural analgesia infusion, induction of labor, uterine stimulation with oxytocin, type of birth, fetal weight, duration of dilation and expulsion, Apgar score (at 1 and 5 minutes), umbilical artery pH, and maternal temperature.
Data for 4364 women were analyzed. Fever developed during labor in 5.7%; 93.7% of the fevers occurred in women receiving epidural analgesia (P<0.05). Logistic regression analysis revealed that independent risk factors for the development of fever were epidural analgesia (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.05-3.04), nulliparity (OR, 2,929; 95% CI, 2.005-4.279), fetal weight (OR, 1.484; 95% CI, 1.102-2.001), and duration of labor (OR, 1.003; 95% CI, 1.003-1.004). No significant differences in Apgar score at 5 minutes or umbilical artery pH were found between the women with and without fever. Tests to rule out sepsis were ordered for 85.1% of the infants of mothers with fever after epidural analgesia.
Epidural analgesia was associated with greater risk of developing fever in mothers giving birth, but that association had no repercussion on the neonatal wellness parameters studied.
研究分娩期间硬膜外镇痛与产妇发热之间的关系，并确定这种关联与新生儿健康以及新生儿败血症排除检查结果之间的可能关系。
对在阿尔科孔基金会医院分娩的所有女性进行为期3年的前瞻性研究。所有女性均接受基于输注0.0625%布比卡因和2微克/毫升的硬膜外镇痛。收集的数据包括年龄、初产情况、硬膜外镇痛输注情况、引产、催产素刺激子宫、分娩类型、胎儿体重、宫口扩张和娩出时间、阿氏评分（1分钟和5分钟时）、脐动脉pH值以及产妇体温。
分析了4364名女性的数据。分娩期间发热的发生率为5.7%；93.7%的发热发生在接受硬膜外镇痛的女性中（P<0.05）。逻辑回归分析显示，发热的独立危险因素为硬膜外镇痛（优势比[OR]，1.78；95%置信区间[CI]，1.05 - 3.04）、初产（OR，2.929；95% CI，2.005 - 4.279）、胎儿体重（OR，1.484；95% CI，1.102 - 2.001）和产程（OR，1.003；95% CI，1.003 - 1.004）。发热和未发热的女性在5分钟时的阿氏评分或脐动脉pH值方面无显著差异。硬膜外镇痛后发热母亲的婴儿中，85.1%接受了败血症排除检查。
硬膜外镇痛与分娩母亲发热风险增加有关，但这种关联对所研究的新生儿健康参数没有影响。
