title: Maternal intrapartum temperature elevation as a risk factor for cesarean delivery and assisted vaginal delivery.
abstract: OBJECTIVE
  This study investigated the association of intrapartum temperature elevation with cesarean delivery and assisted vaginal delivery.
  
  
  METHODS
  Participants were 1233 nulliparous women with singleton, term pregnancies in vertex presentations who had spontaneous labors and were afebrile (temperature: 99.5 degrees F [37.5 degrees C]) at admission for delivery. Rates of cesarean and assisted vaginal deliveries according to highest intrapartum temperature were examined by epidural status.
  
  
  RESULTS
  Women with maximum intrapartum temperatures higher than 99.5 degrees F were 3 times as likely to experience cesarean (25.2% vs 7.2%) or assisted vaginal delivery (25.2% vs 8.5%). The association was present in epidural users and nonusers and persisted after birthweight, epidural use, and labor length had been controlled. In adjusted analyses, temperature elevation was associated with a doubling in the risk of cesarean delivery (odds ratio [OR] = 2.3, 95% confidence interval [CI] = 1.5, 3.4) and assisted vaginal delivery (OR = 2.1, 95% CI = 1.4, 3.1).
  
  
  CONCLUSIONS
  Modest temperature elevation developing during labor was associated with higher rates of cesarean and assisted vaginal deliveries. More frequent temperature elevation among women with epidural analgesia may explain in part the higher rates of cesarean and assisted vaginal deliveries observed with epidural use.
authors: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. 02115, USA. eslieberma@bics.bwh.harvard.edu
authors: E
authors: E
authors: Lieberman
authors: A
authors: A
authors: Cohen
authors: J
authors: J
authors: Lang
authors: F
authors: F
authors: Frigoletto
authors: L
authors: L
authors: Goetzl
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects; D016362:Analgesia, Obstetrical / Q000009:adverse effects; D002585:Cesarean Section / Q000706:statistics & numerical data; D005113:Extraction, Obstetrical / Q000706:statistics & numerical data; D005260:Female; D005334:Fever / Q000209:etiology / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D007744:Obstetric Labor Complications / Q000209:etiology / Q000628:therapy*; D016017:Odds Ratio; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors