Obstetrics Department, Hangzhou Women's Hospital, Hangzhou, China.
Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China.
PeerJ. 2022 Oct 27;10:e14242. doi: 10.7717/peerj.14242. eCollection 2022.
Intrapartum fever is a well-known predisposing factor for severe perinatal outcomes. Herein, we explored the intrapartum features, obstetric outcomes, and neonatal outcomes in relation to the extent of intrapartum fever three group analyses.
A retrospective cohort analysis consisting of 575 term, singleton live births in one medical center from January 1st to December 31st, 2020 was carried out. Parturients who had experienced a maximal intrapartum fever of <38.0 °C were compared with two sub-groups of parturients who had experienced respective maximal fevers of 38.0-38.9 °C and ≥39.0 °C. We computed the adjusted risks for adverse perinatal outcomes multiple logistic regression models to control for confounders.
There were statistically remarkable differences among the three groups in 13 items including body mass index, epidural, and WBC before delivery ( < 0.05). In contrast with intrapartum fevers of 37.5-37.9 °C, intrapartum fevers of 38.0-38.9 °C were linked to an elevated risk of neonatal sepsis and neonatal intensive care unit admission with an odds ratio (OR) of 4.28 (95% CI 2.162-8.479) and 1.73 (95% CI 1.125-2.666), nonetheless, the relationship was remarkably higher for intrapartum fever ≥39.0 °C, with an OR of 6.40 (95% CI 2.450-16.725) and 2.23 (95% CI 1.021-4.854). Additionally, intrapartum fevers of 38.0-38.9 °C and ≥39.0 °C were related to remarkably higher risk for operative deliveries (OR 2.24, 95% CI 1.373-3.648; OR 3.59, 95% CI 1.398-9.226; respectively) and histological chorioamnionitis (OR 3.77, 95% CI 2.261-6.271; OR 19.24, 95% CI 7.385-50.111, respectively).
Intrapartum fever is an important indicator of adverse perinatal outcomes. The higher the temperature, the higher risk of histological chorioamnionitis, as well as the risk of neonatal sepsis and neonatal intensive care unit admission.
产时发热是导致严重围产儿结局的已知危险因素。在此，我们通过三组分析探讨了与产时发热程度相关的产时特征、产科结局和新生儿结局。
对 2020 年 1 月 1 日至 12 月 31 日在一家医疗中心分娩的 575 例足月、单胎活产的回顾性队列进行了分析。与经历最大产时发热<38.0°C 的产妇相比，我们比较了经历最大产时发热分别为 38.0-38.9°C 和≥39.0°C 的两组产妇。我们通过多因素逻辑回归模型计算了不良围产儿结局的调整风险，以控制混杂因素。
三组在 13 项指标中存在统计学差异，包括体重指数、硬膜外麻醉和分娩前白细胞计数（<0.05）。与产时发热 37.5-37.9°C 相比，产时发热 38.0-38.9°C 与新生儿败血症和新生儿重症监护病房入院的风险增加相关，比值比（OR）分别为 4.28（95%CI 2.162-8.479）和 1.73（95%CI 1.125-2.666），而产时发热≥39.0°C 的关系更为显著，OR 分别为 6.40（95%CI 2.450-16.725）和 2.23（95%CI 1.021-4.854）。此外，产时发热 38.0-38.9°C 和≥39.0°C 与剖宫产分娩（OR 2.24，95%CI 1.373-3.648；OR 3.59，95%CI 1.398-9.226）和组织学绒毛膜羊膜炎（OR 3.77，95%CI 2.261-6.271；OR 19.24，95%CI 7.385-50.111）的风险显著增加有关。
产时发热是不良围产儿结局的重要指标。体温越高，组织学绒毛膜羊膜炎的风险越高，以及新生儿败血症和新生儿重症监护病房入院的风险越高。
