Analysis the effect of epidural labor analgesia on maternal intrapartum fever based on propensity score matching method
Objective To analyse the effect of epidural labor analgesia on maternal intrapartum fever based on propensity score matching method.Methods We retrospectively analyzed 384 cases of primiparas undergoing successful vaginal delivery from January 2022 to July 2022 in Changzhou Maternal and Health Care Hospital,meeting full term pregnancy with singleton in cephalic presentation,aged 20 to 35 years,ASA grade Ⅰ～Ⅱ,who were divided into two groups depended on with or without requesting for epidural labor analgesia:analgesia group,a total of 250 cases,and controlled group,a total of 134 cases.When the cervical dilatation of analgesia group parturients was about 3 cm,a epidural analgesia pump was placed at the L2～L3 interspace containing 0.1%ropivacaine plus 0.5 μg/ml sufentanil.The basal body temperature,body mass index(BMI),the time from rupture of fetal membrane to the end of labor,the number of vaginal examinations,the length of labor,use of oxytocin and neonatal weight were recorded.Venous blood samples of parturients at prenatal and 24 h postpartum were collected to detect white blood cells(WBC),neutral granular cells(NEUT),C-reactive protein(CRP),procalcitonin(PCT).Placental pathology analysis was obtained when maternal intrapartum temperature was≥37.5℃.The propensity score matching method was used for paired screening,with 112 cases in analgesia group and 112 cases in controlled group.The primary outcome was incidence of maternal intrapartum temperature≥37.5℃.Secondary outcomes included incidence of chorioamnionitis,amniotic fluids pollution,Apgar scores of newborns at 1min and 5 min after delivery.Results Compared with the control group,the incidence of maternal intrapartum temperature≥37.5℃was significantly higher in the analgesia group(P＜0.05).No significant changes were found in chorioamnionitis and amniotic fluids pollution between two groups(P＞0.05).There was no significant changes in the incidence of newborn Apgar scores＜7 at 1 min and 5 min after delivery between two groups(P＞0.05).Conclusion Epidural labor analgesia provided a higher incidence of maternal intrapartum fever,the underlying mechanism may due to non-infection factor.
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