The Influencing Factors of Delayed Onset of Intrapartum Fever Related to In-trathecal Labor Analgesia and its Impact on Maternal and Neonatal Outcomes
- VernacularTitle:椎管内分娩镇痛相关产时发热出现时刻延迟的影响因素及对母婴结局的影响
- Author:
Fei JIA
1
;
Liang LING
;
Bo LIU
;
Chunping LI
;
Huiru LI
;
Xiangli SHEN
;
Mengjiao WANG
;
Dan ZHANG
;
Jian ZHANG
Author Information
1. 成都市锦江区妇幼保健院麻醉科,四川成都 610011
- Publication Type:Journal Article
- Keywords:
Epidural labor analgesia;
Intrapartum fever;
Timing of onset;
Influencing factors;
Maternal and neonatal outcomes
- From:
Journal of Practical Obstetrics and Gynecology
2025;41(2):169-173
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the factors influencing the delayed onset of intrapartum fever following epidural labor analgesia and their impact on maternal and neonatal outcomes.Methods:Select parturients who experienced intrapartum fever following labor analgesia(T≥38.0℃,age≥18 years,singleton pregnancy,ASA classification Ⅱ)between January 1,2021,and December 31,2023.Group them based on the median time of intra-partum fever onset after labor analgesia:those with onset times less than the median were classified as the ear-ly-onset fever group,and those with onset times greater than the median were classified as the late-onset fever group.Using univariate and multivariate Logistic regression analysis to explore factors influencing the delay in in-trapartum fever onset and the pregnancy outcomes of the mothers and newborns in both groups.Results:A total of 253 parturients were included,and the time range of onset of intrapartum fever following epidural labor analgesi-a was 1.83-28.42 hours,with a median fever onset time of 8.00 hours.There were 126 cases in the early-onset group and 127 in the late-onset group.Multivariate Logistic regression analysis indicated that primiparous women,artificial membrane rupture,and neonatal birth weight were independent risk factors for delayed fever onset(OR＞1,P＜0.05),whereas the administration of oxytocin prior to labor analgesia was found to be a protective factor(OR＜1,P＜0.05).The late-onset group exhibited higher levels of white blood cells(WBC),C-reactive pro-tein,longer hospital stays,higher hospitalization costs,greater diagnosis rates of chorioamnionitis,higher NICU ad-mission rates,as well as a higher incidence of neonatal pneumonia,for newborns compared to the early-onset group(P＜0.05).Conclusions:Primiparous women,artificial membrane rupture,and higher neonatal birth weight may be associated with delayed onset of intrapartum fever,while oxytocin administration prior to labor analgesia may offer some protective benefit.The later the onset of intrapartum fever,the worse the clinical outcomes for both mother and infants.
