title: Very High Intrapartum Fever in Term Pregnancies and Adverse Obstetric and Neonatal Outcomes.
abstract: BACKGROUND
  Intrapartum fever is a well-known risk factor for adverse perinatal outcomes. Maternal intrapartum fever ≥39.0°C at term is a rare event during labor, and there is scarce evidence regarding its implications.
  
  
  OBJECTIVE
  To investigate the association between very high intrapartum maternal fever and perinatal outcomes in term pregnancies.
  
  
  METHODS
  A retrospective cohort analysis including 43,560 term, singleton live births in two medical centers between the years 2003 and 2011 was performed. We compared parturients who experienced a maximal intrapartum fever of <38.0°C with two subgroups of parturients who experienced respective maximal fevers of 38.0-38.9°C and ≥39°C. Adjusted risks for adverse perinatal outcomes were calculated by using multiple logistic regression models to control for confounders.
  
  
  RESULTS
  Compared with normal intrapartum temperature, intrapartum fever ≥39.0°C was associated with an extremely elevated risk for neonatal sepsis 16.08 (95% CI: 2.15, 120.3) as well as with low Apgar scores and neonatal intensive care unit admissions (p < 0.001). Additionally, very high intrapartum fever was related to significantly higher risk for operative delivery (p < 0.001).
  
  
  CONCLUSIONS
  Extremely elevated intrapartum fever is an important indicator of severe neonatal morbidity and operative delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel.
authors.forename: Uri P
authors.initials: UP
authors.lastname: Dior
authors.forename: Liron
authors.initials: L
authors.lastname: Kogan
authors.forename: Smadar
authors.initials: S
authors.lastname: Eventov-Friedman
authors.forename: Moran
authors.initials: M
authors.lastname: Gil
authors.forename: Raz
authors.initials: R
authors.lastname: Bahar
authors.forename: Zivanit
authors.initials: Z
authors.lastname: Ergaz
authors.forename: Shay
authors.initials: S
authors.lastname: Porat
authors.forename: Ronit
authors.initials: R
authors.lastname: Calderon-Margalit
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D005334:Fever; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology*; D007557:Israel; D016015:Logistic Models; D015999:Multivariate Analysis; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology*; D047929:Term Birth; D055815:Young Adult