Risk factors of intrapartum fever
10.3760/cma.j.cn113903-20230822-00142
- VernacularTitle:产时发热的影响因素
- Author:
Wensheng AN
1
;
Li LIN
Author Information
1. 北京大学国际医院妇产科，北京 102206
- Keywords:
Obstetric labor complications;
Fever;
Analgesia, obstetrical;
Fetal membranes, premature rupture;
Risk factors;
Case-control studies
- From:
Chinese Journal of Perinatal Medicine
2024;27(5):402-405
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the influencing factors of intrapartum fever.Methods:A retrospective analysis was conducted on 357 women with intrapartum fever (fever group) and 454 without (non-fever group) who underwent prenatal examination and delivered at Peking University International Hospital from May 1, 2017, to May 30, 2020. Clinical data before and during delivery were collected, and univariate and multivariate logistic regression analysis was performed to screen intrapartum fever-related risk factors. Independent sample t-test, Mann Whitney U-test, and Chi-square-test were used to compare groups. Results:(1) The proportions of women with age ≥35 years and anemia were lower in the fever group than those in the non-fever group [10.9% (39/357) vs. 17.0% (77/454), χ2=5.94, P=0.015; 7.3% (26/357) vs. 20.3% (92/454), χ2=27.09, P<0.001]. The total labor duration and the time from membrane rupture to delivery were longer [12.7 h (10.0-16.1 h) vs. 8.0 h (5.4-11.2 h), Z=－6.41; 11.0 h (6.2-17.7 h) vs. 3.1 h (1.1-8.2 h), Z=－6.41; both P<0.001] and the proportions of premature rupture of membranes, labor analgesia, meconium-stained amniotic fluid, vaginitis, and promoting cervical ripening were higher in the fever group than those in the non-fever group [44.3% (158/357) vs. 22.7% (103/434), χ2=42.60; 95.2% (340/357) vs. 53.1% (241/454), χ2=174.79; 31.6% (113/357) vs. 15.0% (68/454), χ2=32.05; 17.1% (61/357) vs. 7.3% (33/454), χ2=18.93; 20.4% (73/357) vs. 6.6% (30/454), χ2=34.53; all P<0.001]. (2) Multivariate logistic analysis showed that premature rupture of membranes ( OR=2.052, 95% CI: 1.172-3.606), labor analgesia ( OR=5.909, 95% CI: 3.238-11.42), total labor duration ( OR=1.231, 95% CI: 1.169-1.299), meconium-stained amniotic fluid ( OR=1.963, 95% CI: 1.267-3.066), and vaginitis ( OR=3.587, 95% CI: 1.943-6.847), cervical ripening promotion ( OR=3.947, 95% CI: 2.243-7.170), and the time from membrane rupture to delivery ( OR=1.045, 95% CI: 1.012-1.081) are independent risk factors for intrapartum fever (all P<0.05). Anemia ( OR=0.358, 95% CI: 0.192-0.647, P<0.05) is a protective factor for intrapartum fever. (3) Premature rupture of membranes ( OR=2.138, 95% CI: 1.189-3.865), prolonged total labor duration ( OR=1.240, 95% CI: 1.174-1.315), vaginitis ( OR=3.353, 95% CI: 1.719-6.926), prolonged time from membrane rupture to delivery ( OR=1.047, 95% CI: 1.013-1.085), meconium-stained amniotic fluid ( OR=2.154, 95% CI: 1.357- 3.466) and cervical ripening promotion ( OR=3.880, 95% CI: 2.136-7.363) are risk factors for intrapartum fever in women receiving delivery analgesia (all P<0.05). Conclusions:The influencing factors of intrapartum fever include premature rupture of membranes, labor analgesia, total labor, meconium-stained amniotic fluid, vaginitis, cervical ripening promotion, time from rupture of membranes to delivery, and anemia. Obstetricians should strengthen the monitoring of maternal temperature and the management of the labor process, pay attention to risk factors of intrapartum fever, and significantly reinforce the management of labor for women with cervical ripening promotion, labor analgesia and premature rupture of membranes to reduce postpartum fever and improve adverse maternal and infant outcomes.
