Neonatal sepsis is mediated by maternal fever in labour epidural analgesia

Wassen, Martine M L H; Winkens, Björn; Dorssers, E.; Marcus, Marianne T.; Moonen, Rob; Roumen, Frans J.M.E.

doi:10.3109/01443615.2014.925858

Cited by 18 publications

(13 citation statements)

References 40 publications

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“…Fetal temperature increases proportionate to the maternal temperature. 68 Kaul et al, 30 Wasson et al, 71 and Agakidis et al 72 also observed neonatal temperature elevation in association with EA.…”

Section: Discussionmentioning

confidence: 92%

<p>Effects of Labor Epidural Analgesia on Short Term Neonatal Morbidity</p>

Salameh¹,

Paraparambil²,

Abedin³

et al. 2020

IJWH

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Background: Epidural Analgesia (EA) is the most effective and most commonly used method for pain relief during labor. Some researchers have observed an association between EA and increased neonatal morbidity. But this observation was not consistent in many other studies. Objectives: The primary objective of the study was to examine whether exposure to epidural analgesia increased the risk of NICU admission. The secondary objectives included the risks of clinical chorioamnionitis, instrumental delivery, neonatal depression, respiratory distress, birth trauma, and neonatal seizure during the first 24 hours of life. Methods: This was a retrospective cohort study involving 2360 low-risk nulliparous women who delivered at AWH, Qatar, during the two years between January 2016 December and 2017. Short-term neonatal outcomes of the mothers who received EA in active labor were compared with a similar population who did not receive EA. As secondary objectives, labor parameters like maternal temperature elevation, duration of the second stage of labor, and instrumental delivery were compared. Results: Significantly higher numbers of neonates were admitted to the NICU from the EA group (P<0.001, OR 1.89, 95% CI 1.45 to 2.46). They were more likely to have respiratory distress (P=0.01, OR 1.49, 95% CI 1.07 to 2.07), birth injuries (P=0.02, OR =1.71, 95% CI 1.06 to 2.74), admission temperature>37.5°C (P=0.04, OR 3.40, 95% CI 1.00 to 11.49), need for oxygen on the first day (P=0.04, OR 1.44, 95% CI 1.01 to 2.07) and receive antibiotics (P<0.001, OR 2.06,95% CI 1.47 to 2.79). There was no difference in the Apgar score at 1 minute (P=0.12), need of resuscitation at birth (P=0.05), neonatal white cell count (P=0.34), platelet count (P=0.38) and C reactive protein (P=0.84). Mothers who received EA had a lengthier second stage (P<0.001), temperature elevation >37.5°C (P<0.001, OR 7.40, 95% CI 3.93 to 13.69) and instrumental delivery (P<0.001, OR 2.13, 95% CI 1.69 to 2.68). Conclusion: EA increases NICU admission, antibiotic exposure, neonatal birth injuries, need for positive pressure ventilation at birth, and respiratory distress in the first 24 hours of life. Mothers on epidural analgesia have prolonged second stage of labor, a higher rate of instrumental delivery, meconium-stained amniotic fluid, fetal distress, and temperature elevation.

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Section: Discussionmentioning

confidence: 92%

<p>Effects of Labor Epidural Analgesia on Short Term Neonatal Morbidity</p>

Salameh¹,

Paraparambil²,

Abedin³

et al. 2020

IJWH

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“…Maternal complications include the need for cesarean or instrumental delivery, while a high proportion of these are indicated by labor dystocia or suspected fetal distress [2][3][4][5] . Fetal complications include neonatal intensive care unit (NICU) admissions 2 , early onset neonatal sepsis 6 , low Apgar scores 2,7 , hypotonia, assisted ventilation, early-onset seizures 7 , neonatal encephalopathy 8 , hyaline membrane disease, and perinatal mortality 9 , as well as cerebral palsy in the long term 10,11 .…”

Section: Introductionmentioning

confidence: 99%

The impact of peak and duration of maternal intrapartum fever on perinatal outcomes

Hochler

Lipschuetz

Guedalia

et al. 2021

American Journal of Obstetrics & Gynecology MFM

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…With epidurals, there are increased risks for the need for urinary catheterization and instrumental birth. Epidurals are also associated with the development of maternal fever during labor, which can lead to separation of mother and baby after birth and testing and antibiotic administration for the baby (Greenwell et al, 2012;Leighton & Halpern, 2002;Lieberman & O'Donoghue, 2002;Wassen et al, 2014).…”

Section: Summary Of the Importance Of Allowing Labor To Begin On Its mentioning

confidence: 99%

Healthy Birth Practice #1: Let Labor Begin on Its Own

Amis¹

2019

J Perinat Educ

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As cesarean rates have climbed to almost one-third of all births in the United States, current research and professional organizations have identified letting labor begin on its own as one of the most important strategies for reducing the primary cesarean rate. At least equally important, letting labor begin on its own supports normal physiology, prevents iatrogenic prematurity, and prevents the cascade of interventions caused by labor induction. This article is an updated evidence-based review of the "Lamaze International Care Practices That

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Neonatal sepsis is mediated by maternal fever in labour epidural analgesia

Cited by 18 publications

References 40 publications

<p>Effects of Labor Epidural Analgesia on Short Term Neonatal Morbidity</p>

<p>Effects of Labor Epidural Analgesia on Short Term Neonatal Morbidity</p>

The impact of peak and duration of maternal intrapartum fever on perinatal outcomes

Healthy Birth Practice #1: Let Labor Begin on Its Own

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