Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel (Dr Hochler, Mss Lipschuetz and Cohen, and Drs Yagel and Walfisch).
Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel (Dr Hochler, Mss Lipschuetz and Cohen, and Drs Yagel and Walfisch); The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel (Ms Lipschuetz and Mr Guedalia).
Am J Obstet Gynecol MFM. 2021 Jul;3(4):100390. doi: 10.1016/j.ajogmf.2021.100390. Epub 2021 May 10.
Intrapartum fever is a common perinatal complication, associated with short- and long-term adverse outcomes. Limited data exist regarding the association between the peak and duration of maternal fever and the extent and severity of maternal and neonatal complications.
This study aimed to examine the association between maternal intrapartum fever peak and duration and perinatal outcomes.
A retrospective cohort analysis of term singleton live births in 2 medical centers between the years 2003 and 2015 was conducted. The study group included parturients who experienced intrapartum fever, defined as a temperature of ≥38.0°C (100.4°F). Fever duration was defined as the time elapsed between the first documented fever and subsequent first documented normal body temperature (<38°C or <100.4°F) or if the temperature did not return to normal until delivery. Adjusted risks for adverse perinatal outcomes were calculated using multiple logistic regression models to control for confounders.
A cohort study of 85,713 deliveries was analyzed, of which 1517 (1.8%) parturients experienced fever during delivery. Adverse composite neonatal outcome gradually worsens, in a dose-response manner, with higher maximal maternal temperature. Similar dose-response deterioration was found when maximal parturient temperature was combined with fever duration (P=.015). Higher or longer maternal fever was not independently associated with cesarean or instrumental deliveries (P=.648). Duration alone was not significantly associated with worsening neonatal outcomes (P=.711).
Maximal intrapartum maternal fever, solely and when combined with fever duration, is correlated with neonatal complications in a dose-dependent manner. Further prospective studies are needed to examine the potential benefit of rigorous maternal body temperature control on perinatal outcomes.
产时发热是一种常见的围产期并发症，与短期和长期不良结局相关。关于产妇发热峰值和持续时间与产妇和新生儿并发症的程度和严重程度之间的关系，数据有限。
本研究旨在探讨产妇产时发热峰值和持续时间与围产结局的关系。
对 2003 年至 2015 年间 2 家医疗中心的足月单胎活产进行回顾性队列分析。研究组包括经历产时发热的产妇，定义为体温≥38.0°C（100.4°F）。发热持续时间定义为从首次记录发热到随后首次记录正常体温（<38°C 或<100.4°F）之间的时间，或者如果体温直到分娩才恢复正常。使用多因素逻辑回归模型调整不良围产结局的调整风险，以控制混杂因素。
对 85713 例分娩的队列研究进行了分析，其中 1517 例（1.8%）产妇在分娩过程中发热。复合不良新生儿结局逐渐恶化，呈剂量反应关系，产妇最高体温越高。当最高产妇体温与发热持续时间相结合时，也发现了类似的剂量反应恶化（P=.015）。较高或较长的产妇发热与剖宫产或器械分娩无关（P=.648）。单独发热持续时间与新生儿结局恶化无显著相关性（P=.711）。
单独的最大产时母体发热，以及与发热持续时间相结合，与新生儿并发症呈剂量依赖性相关。需要进一步的前瞻性研究来检查严格控制母体体温对围产结局的潜在益处。
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