Very High Intrapartum Fever in Term Pregnancies and Adverse Obstetric and Neonatal Outcomes

Background: Intrapartum fever is a well-known risk factor for adverse perinatal outcomes. Maternal intrapartum fever >= 39.0 degrees C at term is a rare event during labor, and there is scarce evidence regarding its implications. Objectives: 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 degrees C with two subgroups of parturients who experienced respective maximal fevers of 38.0-38.9 degrees C and >= 39 degrees 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 degrees 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. (C) 2015 S. Karger AG, Basel