title: Neonatal sepsis is mediated by maternal fever in labour epidural analgesia.
abstract: Women delivering with EA (EA group) were matched on parity with 453 women with deliveries without EA (non-EA group). Significantly more neonates born in the EA-group had fever ≥ 38.0°C (11.6% vs 1.8%, p < 0.001) at birth. The overall incidence of neonatal sepsis, based on clinical symptoms and defined as proven (by a positive blood culture) or suspected (no positive blood culture), was significantly higher in the EA group (6.0% vs 2.2%; p = 0.002), but the incidence of proven neonatal sepsis alone was not (0.4% vs 0%; p = 0.250). EA turned out to be an independent risk factor for neonatal sepsis (adjusted OR 2.43, 95% CI 1.15-5.13; p = 0.020). However, in the EA group as well as the non-EA group, the incidence of neonatal sepsis was significantly higher in mothers with intrapartum fever compared with afebrile mothers (11.0% vs 2.9% in the EA group; p = 0.004; 8.2% vs 1.3% in the non-EA group; p = 0.006). Therefore we conclude, that the positive association between neonatal sepsis and labour EA is possibly mediated by maternal intrapartum fever.
authors.affiliation: Department of Obstetrics and Gynaecology, Atrium Medical Center Parkstad , Heerlen , the Netherlands.
authors.forename: M M L H
authors.initials: MM
authors.lastname: Wassen
authors.forename: B
authors.initials: B
authors.lastname: Winkens
authors.forename: E M I
authors.initials: EM
authors.lastname: Dorssers
authors.forename: M A
authors.initials: MA
authors.lastname: Marcus
authors.forename: R M J
authors.initials: RM
authors.lastname: Moonen
authors.forename: F J M E
authors.initials: FJ
authors.lastname: Roumen
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects*; D005260:Female; D005334:Fever / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018805:Sepsis / Q000151:congenital* / Q000453:epidemiology
keywords: Epidural analgesia; fever; labour; neonatal sepsis