Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel; The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel.
The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel.
Eur J Obstet Gynecol Reprod Biol. 2022 Jun;273:33-37. doi: 10.1016/j.ejogrb.2022.04.011. Epub 2022 Apr 15.
To evaluate neonatal fever and adverse maternal and neonatal outcomes in febrile laboring women and assess whether the time interval between epidural analgesia (EA) administration and chorioamnionitis is associated with these complications.
A retrospective cohort study at a university affiliated medical center between 2003 and 2015. Included were women who underwent term vaginal delivery attempt and diagnosed with chorioamnionitis. The primary outcomes compared between febrile women with and without EA were neonatal fever and adverse neonatal and maternal outcomes. The association between time from EA to fever (<6, 6-12, >12 h) and maternal and neonatal complications was also assessed.
During the study period, 1,933 women with chorioamnionitis were assessed. Of them, 1,810 (93.6%) received EA prior to fever and 123 (6.4%) febrile parturients did not receive EA. Neonatal fever and other neonatal adverse outcomes were similar in the EA vs. non-EA group (2.2% vs. 0.8% and 2.7% vs. 4.9% (NS)), except for transient tachypnea of the newborn rates which were lower in the EA group (1.4% vs. 4.1%, p = 0.043). Maternal complications were similar, besides for higher rates of instrumental deliveries found in the EA group (24.0% vs. 5.7%, p < 0.001). Time between EA and fever onset was not associated with neonatal complications in logistic regression analysis.
Neonatal and maternal outcomes are similar in febrile laboring women with and without EA. The time interval between EA and onset of fever is not associated with increased rates of neonatal fever or adverse outcomes and should not affect the management of labor.
评估发热产妇的新生儿发热和不良母婴结局，并评估硬膜外镇痛（EA）与绒毛膜羊膜炎之间的时间间隔是否与这些并发症相关。
这是一项在 2003 年至 2015 年期间在一家大学附属医院进行的回顾性队列研究。研究对象为接受足月阴道分娩并诊断为绒毛膜羊膜炎的产妇。比较发热产妇和无 EA 产妇的主要结局是新生儿发热和不良新生儿及母婴结局。还评估了从 EA 到发热（<6、6-12、>12 小时）的时间间隔与母婴并发症之间的关系。
在研究期间，评估了 1933 例患有绒毛膜羊膜炎的妇女。其中 1810 例（93.6%）在发热前接受了 EA，123 例（6.4%）发热产妇未接受 EA。EA 组与非 EA 组的新生儿发热和其他新生儿不良结局相似（2.2% vs. 0.8%和 2.7% vs. 4.9%（NS）），但新生儿暂时性呼吸急促的发生率较低（1.4% vs. 4.1%，p=0.043）。除 EA 组器械分娩率较高（24.0% vs. 5.7%，p<0.001）外，母婴并发症相似。Logistic 回归分析显示，EA 与发热发作之间的时间间隔与新生儿并发症无关。
发热产妇 EA 与非 EA 组的新生儿和母婴结局相似。EA 与发热发作之间的时间间隔与新生儿发热或不良结局的发生率增加无关，不应影响分娩管理。
