Intrapartum fever, epidural analgesia and histologic chorioamnionitis

Abstract

OBJECTIVE:Our objective was to determine whether epidural analgesia and histologic chorioamnionitis were independent predictors of intrapartum fever.Study Design:This secondary analysis, retrospective cohort study included term parturients with placental examination during 2005. Logistic regression used fever (≥38 °C) as the dependent variable. Significance was defined as P≤0.05.Result:There were 488 (76%) of 641 term parturients with placental examination and epidural. Independent predictors of intrapartum fever were epidural odds ratio (OR)=3.4, confidence interval (CI): 1.70, 6.81, histologic chorioamnionitis OR=3.18, 95% CI: 2.04, 4.95, birthweight OR=2.07, 95%CI: 1.38, 3.12, vaginal exams OR=1.15, 95% CI:1.06, 1.24, duration ruptured membranes OR=1.03, 95% CI: 1.01,1.05, parity≥1 OR=0.44: 0.29, 0.66 and thick meconium OR=0.35: 95%CI: 0.24, 0.85.Conclusion:Epidural analgesia and histologic chorioamnionitis were independent predictors of intrapartum fever. Modification of labor management may reduce the incidence of intrapartum fever.