Clinical risk factors maternals of gestants with intrapartal fever and corioamnionitis.

Abstract

OBJECTIVE: To analyze the maternal clinical risk factors of pregnant women with intrapartum fever and chorioamnionitis. MATERIALS AND METHODS: Retrospective descriptive observational study (2007-2009) and prospective (2010-2012) conducted in the Canary Islands Maternal and Childhood University Hospital Complex in the identification of pregnant women with chorioamnionitis or intrapartum fever. Patients with gestational age equal to or greater than 24 weeks with negative or positive exudate and possibility of vaginal delivery were included and antepartum fetal deaths, patients with contraindication for vaginal delivery, multiple gestations and vagino-rectal exudate for group B streptococcus unknown or not valuable were excluded. Risk factors were studied using multivariate logistic regression models, using the Enter method. RESULTS: After applying the inclusion and exclusion criteria, 4831 patients remained in the study. Of these, 1856 patients diagnosed with chorioamnionitis and 420 patients diagnosed with intrapartum fever, the rest was the control group. The risk factors for intrapartum fever and chorioamnionitis, respectively, were smoking, nulliparity, start of induction labor, oxytocin, epidural analgesia, internal monitoring and meconial fluid. Having a previous caesaren section acted as a protective factor against not having it.CONCLUSIONS: Smoking, nulliparity, spontaneous rupture of membranes, induction of labor, use of oxytocin, administration of epidural analgesia, internal monitoring and meconium fluid are significant risk factors for intrapartum fever and chorioamnionitis. In addition, the time of dilation is also a risk factor for chorioamnionitis, not for intrapartum fever. Maternal age greater than or equal to 36 years is a protective factor for chorioamnionitis.