Association between epidural-related maternal fever and short-and long-term prognosis of parturients: A prospective observational study

Li, Bing; Liao, Yicong; Wang, Qingning; He, Shiyuan; Jia, Junxiang; Zhao, Baisong

doi:10.3389/fsurg.2022.1064272

Cited by 2 publications

(4 citation statements)

References 13 publications

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“…Laboring women often require the quicker onset provided by the dural puncture epidural technique and early-NA to alleviate pain during cervical dilation of less than 2-3 cm [ 13 , 14 ]. At the same time, NA is associated with a prolonged duration of first, second and total stage of labor [ 2 , 15 , 16 ], intrapartum CD, operative vaginal delivery [ 15 ], intrapartum fever [ 3 , 4 ], and adverse maternal and neonatal outcomes [ 17 ]. With the implementation of the three-child policy, there has been an increase in multiparous women opting for vaginal delivery in China.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have consistently reported a significant increase in the incidence of intrapartum fever among parturients who received NA [ 3 , 4 , 19 ]. Intrapartum fever was associated with intrapartum CD, operative vaginal delivery, and PHH.…”

Section: Discussionmentioning

confidence: 99%

“…Globally, neuraxial analgesia (NA) provides satisfactory pain relief during labor. However, its historical development has been linked to undesirable outcomes such as prolonged labor, an increased need for operative delivery, intrapartum cesarean delivery (CD), and intrapartum fever [ 2 – 4 ]. NA has been shown to prolong the first stage of labor by approximately 30 min and the second stage by 15 min compared to other forms of analgesia [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study

Cheng,

Xiong,

et al. 2024

BMC Anesthesiol

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Background The mechanism underlying maternal fever and prolonged labor progression associated with neuraxial analgesia (NA) remains elusive, raising concerns among certain pregnant women regarding the application of NA during vaginal delivery. This study aimed to investigate the impact of early and late NA on maternal and neonatal outcomes in multiparous women. Methods This retrospective study collected data from 1119 multiparous women with singleton pregnancies, full term and live births at our labor and delivery center between August 1st, 2021 and July 31st, 2022. Based on the timing of NA initiation, participants were categorized into three groups: no-NA, early-NA and late-NA. The no-NA group comprised of 172 women who did not receive NA during vaginal delivery; the early-NA group included 603 women in which NA was initiated when cervical dilation was between 0.5 and 2.0 cm; and the late-NA group comprising 344 cases in which NA was initiated at the cervical dilation of ≥ 2 cm. Maternal and neonatal outcomes were observed, including durations of the first, second, third and total stage of labor, the rate of intrapartum cesarean delivery (CD), intrapartum fever, postpartum hemorrhage (PPH), transfer to intensive care unit (ICU), admission to the neonatal intensive care unit (NICU), meconium-stained amniotic fluid, and neonatal Apgar scores at 1 and 5 min. Results No differences were noted in the maternal age, body mass index (BMI) on admission, gestations, parity, gestational weeks at delivery and neonatal birth weight, or the rate of gestational diabetes mellitus (GDM) and hypertension disorder did not significantly differ among the three groups (p > 0.05). The no-NA group had shorter durations of first stage, second stage of labor compared to the early-NA or late-NA group (median, 215.0 min and 10.0 min vs. 300.0 min and 12.0 min vs. 280.0 min and 13.0 min) (p < 0.05), but no differences were observed between the early-NA and late-NA group (p > 0.05). There were no differences in the rate of intrapartum CD, intrapartum fever, PPH, maternal transferred to ICU, neonatal transfer to NICU, meconium-stained amniotic fluid, and postpartum stay ≥ 7d, as well as the neonatal the Apgar scores at 1 and 5 min among the three groups (p > 0.05). Conclusion NA is associated with extended durations of the first, second and total stages of labor. However, the early initiation of NA in multiparous women (cervical dilation within 0.5-2.0 cm) does not increase the risk of intrapartum CD or intrapartum fever. These findings endorse the secure utilization of early NA for pain relief during labor in multiparous women.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study

Cheng,

Xiong,

et al. 2024

BMC Anesthesiol

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“…Therefore, antibiotic administration is recommended to manage maternal fevers (Goetzl, 2023). Although approximately 90% of pregnant women with ERMF show improvement within hours of delivery (Gonen et al, 2000), studies on the relationship between ERMF and long-term outcomes are limited (Li et al, 2022). While the current management of ERMF presents challenges, the potential role of IL-1ra in preventing ERMF represents an exciting frontier in maternal healthcare and will be the focus of the following discussion.…”

Section: Challenges In Managing Ermfmentioning

confidence: 99%

Fever in childbirth: a mini-review of epidural-related maternal fever

Kinishi,

Koyama,

Yuba

et al. 2024

Front. Neurosci.

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Fever during childbirth, which is often observed in clinical settings, is characterized by a temperature of 38°C or higher, and can occur due to infectious and non-infectious causes. A significant proportion of non-infectious causes are associated with epidural-related maternal fever during vaginal delivery. Therapeutic interventions are required because fever has adverse effects on both mother and newborn. Effective treatment options for ERMF are lacking. As it is difficult to distinguish it from intrauterine infections such as chorioamnionitis, antibiotic administration remains the only viable option. We mentioned the importance of interleukin-1 receptor antagonist in the sterile inflammatory fever pathway and the hormonal influence on temperature regulation during childbirth, an important factor in elucidating the pathophysiology of ERMF. This review spotlighted the etiology and management of ERMF, underscoring recent advancements in our understanding of hypothalamic involvement in thermoregulation and its link to sterile inflammation. We propose to deepen the understanding of ERMF within the broader context of autonomic neuroscience, aiming to foster the development of targeted therapies.

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Association between epidural-related maternal fever and short-and long-term prognosis of parturients: A prospective observational study

Cited by 2 publications

References 13 publications

Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study

Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study

Fever in childbirth: a mini-review of epidural-related maternal fever

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