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产时发热、硬膜外镇痛与组织学绒毛膜羊膜炎。

Intrapartum fever, epidural analgesia and histologic chorioamnionitis.

作者信息

Curtin W M, Katzman P J, Florescue H, Metlay L A, Ural S H

机构信息

1] Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Rochester School of Medicine & Dentistry, Rochester, NY, USA [2] Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Pennsylvania State University College of Medicine, Hershey, PA, USA.

Department of Pathology & Laboratory Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, USA.

出版信息

J Perinatol. 2015 Jun;35(6):396-400. doi: 10.1038/jp.2014.235. Epub 2015 Feb 12.

Abstract

OBJECTIVE

Our objective was to determine whether epidural analgesia and histologic chorioamnionitis were independent predictors of intrapartum fever.

STUDY DESIGN

This secondary analysis, retrospective cohort study included term parturients with placental examination during 2005. Logistic regression used fever (⩾38 °C) as the dependent variable. Significance was defined as P⩽0.05.

RESULT

There were 488 (76%) of 641 term parturients with placental examination and epidural. Independent predictors of intrapartum fever were epidural odds ratio (OR)=3.4, confidence interval (CI): 1.70, 6.81, histologic chorioamnionitis OR=3.18, 95% CI: 2.04, 4.95, birthweight OR=2.07, 95%CI: 1.38, 3.12, vaginal exams OR=1.15, 95% CI:1.06, 1.24, duration ruptured membranes OR=1.03, 95% CI: 1.01,1.05, parity⩾1 OR=0.44: 0.29, 0.66 and thick meconium OR=0.35: 95%CI: 0.24, 0.85.

CONCLUSION

Epidural analgesia and histologic chorioamnionitis were independent predictors of intrapartum fever. Modification of labor management may reduce the incidence of intrapartum fever.

摘要

目的

我们的目的是确定硬膜外镇痛和组织学绒毛膜羊膜炎是否为产时发热的独立预测因素。

研究设计

这项二次分析、回顾性队列研究纳入了2005年进行胎盘检查的足月产妇。逻辑回归以发热(≥38°C)作为因变量。显著性定义为P≤0.05。

结果

641例足月产妇中有488例(76%)进行了胎盘检查和硬膜外镇痛。产时发热的独立预测因素为:硬膜外镇痛优势比(OR)=3.4,置信区间(CI):1.70, 6.81;组织学绒毛膜羊膜炎OR=3.18,95%CI:2.04, 4.95;出生体重OR=2.07,95%CI:1.38, 3.12;阴道检查OR=1.15,95%CI:1.06, 1.24;胎膜破裂持续时间OR=1.03,95%CI:1.01, 1.05;经产妇≥1次OR=0.44:0.29, 0.66;胎粪黏稠OR=0.35:95%CI:0.24, 0.85。

结论

硬膜外镇痛和组织学绒毛膜羊膜炎是产时发热的独立预测因素。改变分娩管理方式可能会降低产时发热的发生率。

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