Association of maternal fever during labor with neonatal and infant morbidity and mortality.
OBJECTIVE
To examine the association of intrapartum fever with infant morbidity and early neonatal (0-6 days) and infant (0-364 days) death.


METHODS
We carried out a retrospective cohort analysis among singleton live births in the United States for the period 1995-1997 using the National Center for Health Statistics linked birth-infant death cohort data.


RESULTS
Among the 11,246,042 singleton live births during the study period, intrapartum fever (at least 38C) was recorded in 1.6%. Intrapartum fever was associated with early neonatal (adjusted odds ratio [OR], 95% confidence interval [CI] for preterm and term infants respectively: 1.32; 1.11, 1.56 and 1.67; 1.14, 2.46) and infant (OR, 95% CI for preterm and term, respectively: 1.31; 1.14, 1.51 and 1.27; 1.01, 1.59) death among nulliparous mothers. Among preterm infants of parous mothers, intrapartum fever was associated with early neonatal (OR 1.29, 95% CI 1.01, 1.64) death. In the combined analyses (infants of nulliparous and parous mothers), intrapartum fever was a strong predictor of infection-related death. These associations were stronger among term (OR 3.16, 95% CI 1.56, 6.40 for early neonatal; OR 1.75, 95% CI 1.20, 2.57 for infant death) than preterm infants (OR 1.52, 95% CI 1.15, 2.00 for early neonatal; OR 1.29, 95% CI 1.05, 1.57 for infant death). Intrapartum fever was also a risk factor for meconium aspiration syndrome, hyaline membrane disease, neonatal seizures, and assisted ventilation.


CONCLUSIONS
Intrapartum fever is an important predictor of neonatal morbidity and infection-related mortality.
Petrova
A
A
Department of Family Medicine, University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School (RWJMS), Piscataway, New Jersey, USA.
Demissie
K
K
Rhoads
G G
GG
Smulian
J C
JC
Marcella
S
S
Ananth
C V
CV
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005334:Fever; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology* / Q000401:mortality*; D007744:Obstetric Labor Complications; D016017:Odds Ratio; D011247:Pregnancy; D012044:Regression Analysis; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology