WESTPORT, Jan 19 (Reuters Health) - Women who develop fever during labor are much more likely to have received epidural analgesia than women who do not, Boston researchers report in the January issue of Pediatrics. If greater than 101 degrees Fahrenheit, fever is likely to have a negative influence on early neonatal outcome.
Dr. Ellice Lieberman, from Harvard Medical School, Boston, Massachusetts, and colleagues there and at the Boston University School of Public Health investigated the association between elevated maternal temperature and early neonatal outcome in 1,218 mother-infant pairs. The researchers found that 16.6% of women given an epidural for pain relief developed fever of 100.5 degrees Fahrenheit or greater during labor, versus only 0.6% of women who did not receive epidural analgesia. "Of febrile women, 97.6% had received epidural analgesia for pain relief," they write. The mean time from epidural to fever was 5.9 hours.
The researchers found that babies born to women whose fevers were over 101 degrees Fahrenheit during labor "...were almost 4 times as likely to have a 1-minute Apgar score <7 than were infants of afebrile mothers." They were also more likely to need bag and mask resuscitation immediately after delivery, to need oxygen therapy in thenursery, and to have a seizure during the neonatal period.
Infants born to mothers whose fevers were 100.5 degrees Fahrenheit or greater were more likely than others to be hypotonic. Tone was normal by the time of hospital discharge, and Apgar scores rose by 5 minutes of age, although they remained lower than for infants of afebrile women. The researchers call for studies to evaluate whether any lasting injury to infants occurs, especially following seizures.
Pediatrics 2000;105:8-13.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]
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