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From:
"G. Hertz" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 23 Jan 2000 14:20:25 -0800
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Thought I'd share this with everyone.  G Hertz, MD, IBCLC

Intrapartum Fever Common With Epidural; Has Adverse Effect on Infant


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 the nursery, 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.

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