title: Risk Factors for Intrapartum Fever in Term Gestations and Associated Maternal and Neonatal Sequelae.
abstract: OBJECTIVE
  To determine factors associated with intrapartum fever and to examine associated maternal and neonatal outcomes.
  
  
  METHODS
  Retrospective study of patients between 360/7 and 420/7 gestational weeks who entered spontaneous or induced active labor and developed temperature ≥38°C; a similar group that did not develop fever were controls. Univariate and multivariate analyses were performed with p < 0.05 as significant.
  
  
  RESULTS
  Fifty-four febrile patients and 306 nonfebrile controls met inclusion criteria. Nulligravidity (45.8 vs. 77.8%, p < 0.001), length of first stage ≥720 min (OR 3.59, 95% CI 1.97-6.55, p < 0.001), length of second stage ≥120 min (OR 4.76, 95% CI 2.29-9.89, p < 0.001), membrane rupture ≥240 min (46.4 vs. 79.6%, p < 0.001), increasing number of vaginal exams (4 vs. 6, p < 0.001), oxytocin (44.8 vs. 63.0%, p = 0.014), and meperidine (14.7 vs. 35.2%, p < 0.001) were all associated with intrapartum fever. Associated morbidity included cesarean delivery (22.5 vs. 44.4%, p = 0.001), Apgar score <7 at 5 min (0.7 vs. 5.6%, p = 0.011), and neonatal intensive care unit admission (9.5 vs. 51.9%, p < 0.001).
  
  
  CONCLUSIONS
  We have identified several noninfectious factors that are associated with intrapartum fever. Modification of risk factors may improve both maternal and neonatal outcomes.
authors.affiliation: Richmond University Medical Center, Department of Obstetrics and Gynecology, Valhalla, New York, USA.
authors.forename: Angela P H
authors.initials: APH
authors.lastname: Burgess
authors.forename: Justin E
authors.initials: JE
authors.lastname: Katz
authors.forename: Michael
authors.initials: M
authors.lastname: Moretti
authors.forename: Nisha
authors.initials: N
authors.lastname: Lakhi
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000209:etiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007751:Labor, Induced / Q000009:adverse effects; D008614:Meperidine / Q000009:adverse effects; D007744:Obstetric Labor Complications / Q000209:etiology; D010121:Oxytocin / Q000009:adverse effects; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid; D010121:Oxytocin; D008614:Meperidine
keywords: Acetaminophen; Cesarean section; Maternal fever; Morbidity; Noninfectious etiology; Risk factors