硬膜外分娩镇痛后产时发热的影响因素。
Influencing factors of intrapartum fever after epidural labor analgesia.
机构信息
Fuzhou Maternal and Child Health Hospital, Department of Anesthesiology - Fuzhou, China.
Fuzhou Maternal and Child Health Hospital, Department of Obstetrics - Fuzhou, China.
出版信息
Rev Assoc Med Bras (1992). 2024 Oct 25;70(11):e20240565. doi: 10.1590/1806-9282.20240565. eCollection 2024.
OBJECTIVE
The objective of this study was to investigate factors influencing intrapartum fever in parturients receiving epidural labor analgesia.
METHODS
This study included 410 parturients who received epidural labor analgesia at the authors' hospital between February 2022 and February 2024. Participants were divided into a fever group (>37.5℃) and a control group (<37.5℃) based on their body temperature post-analgesia. General data, gestational comorbidities, and intrapartum-related conditions were compared. Influencing factors were analyzed using the chi-squared test and logistic regression.
RESULTS
Intrapartum fever occurred in 90 parturients (22.0%). Univariate analysis indicated that maternal age (p=0.046), parity (p=0.042), oxytocin use (p=0.041), and timing of analgesia (p<0.001) were associated with intrapartum fever. Multivariate analysis revealed that the timing of analgesia (OR 3.612, 95%CI 1.533-8.510) and amniotic fluid contamination degrees I (OR 1.072, 95%CI 1.012-3.082) and II (OR 2.874, 95%CI 1.901-9.092) were independent risk factors. No significant differences were found between the fever and control groups in body mass index, gestational age, gestational comorbidities, and artificial membrane rupture (p>0.05). Intrapartum fever increased the rate of neonatal fever within 2 h after birth (41.7 vs 18.6%, p<0.05) but did not significantly affect other neonatal health indicators.
CONCLUSION
Timing of analgesia and amniotic fluid contamination are significant factors influencing intrapartum fever in parturients receiving epidural labor analgesia.
目的
本研究旨在探讨接受硬膜外分娩镇痛产妇产时发热的影响因素。
方法
本研究纳入了 2022 年 2 月至 2024 年 2 月在作者医院接受硬膜外分娩镇痛的 410 名产妇。根据术后体温，将参与者分为发热组（>37.5℃）和对照组（<37.5℃）。比较一般资料、妊娠合并症和产时相关情况。采用卡方检验和 logistic 回归分析影响因素。
结果
90 名产妇（22.0%）发生产时发热。单因素分析表明，产妇年龄（p=0.046）、产次（p=0.042）、催产素使用（p=0.041）和镇痛时机（p<0.001）与产时发热有关。多因素分析显示，镇痛时机（OR 3.612，95%CI 1.533-8.510）和羊水污染程度 I（OR 1.072，95%CI 1.012-3.082）和 II（OR 2.874，95%CI 1.901-9.092）是独立的危险因素。发热组和对照组在 BMI、孕周、妊娠合并症和人工膜破裂方面无显著差异（p>0.05）。产时发热使新生儿出生后 2 h 内发热的发生率增加（41.7% vs 18.6%，p<0.05），但对其他新生儿健康指标无显著影响。
结论
镇痛时机和羊水污染是接受硬膜外分娩镇痛产妇产时发热的重要影响因素。
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