The impact of peak and duration of intrapartum fever on adverse perinatal maternal and neonatal outcomes
Objective To explore the impact of maternal intrapartum fever's peak and duration on perinatal outcomes.Methods This study included primiparas who delivered at term with a singleton fetus in the Shantou Central Hospital from 2020 to 2022.The exposure factor was intrapartum fever(the maternal body temperature≥37.5 ℃).The participants were grouped based on different fever peak(Tmax,the highest recorded body temperature during labor),fever duration(t,the time from the first recorded fever to the first recorded normal body temperature or delivery),and fever composite variable v,[v=Tmax-37℃/100×t].The study compared the differences in neonatal outcomes(including neonatal asphyxia,neonatal infections,hypoxic-ischemic encephalopathy,seizures,intracranial hemorrhage,etc.)and adverse perinatal outcomes of pregnant women(including maternal operative delivery,postpartum hemorrhage,incision infection,puerperal sepsis).Logistic regression analysis was conducted to assess the association between the peak and duration of intrapartum fever and adverse perinatal outcomes.Results A total of 2 197 parturients were included in the study,and 307(13.9％)of them had intrapartum fever.Compared with afebrile parturients,febrile parturients had higher rates of neonatal adverse outcomes and maternal operative delivery.After adjusting for confounding factors,for every 1 ℃ increase in fever peak,the risk of adverse neonatal outcomes increased by 1.204 times(OR=2.204,95％CI:1.691-2.423),and the risk of maternal operative delivery increased by 88.3％(OR=1.883,95％CI:1.581-2.242);for every 60-minute increase in the duration of fever,the risk of adverse neonatal outcomes increased by 28.4％(OR=1.284,95％CI:1.178-1.400),and the risk of maternal operative delivery increased by 29.4％(OR=1.294,95％CI:1.183-1.414);for every 1 unit increase in the composite variable of fever,the risk of adverse neonatal outcomes increased by 55.4％(OR=1.554,95％CI:1.359-1.777),and the risk of maternal operative delivery increased by 49.4％(OR=1.494,95％CI:1.298-1.720).Conclusions Increased peak fever,increased duration of fever,and increased composite fever variables were associated with higher risk of adverse neonatal outcomes and maternal operative delivery.
万方数据
维普
