Epidural analgesia during labor and maternal fever

John Philip, James M. Alexander, Shiv K. Sharma, Kenneth J. Leveno, Donald D. McIntire, Jackie Wiley

Research output: Contribution to journalArticlepeer-review

119 Scopus citations

Abstract

Background: In recent observational studies, epidural analgesia during labor at patient request has been associated with maternal fever. The authors report a secondary analysis of fever in women who were randomized to receive either epidural or patient-controlled intravenous analgesia during labor. Methods: Maternal tympanic temperature was measured during spontaneous labor in 715 women at term who were randomized to either epidural analgesia with bupivacaine and fentanyl or to patient-controlled intravenous analgesia with meperidine. Intent-to-treat analysis of women with fever (temperature ≥ 38.0°C) versus those without was performed using Student t test and Fisher exact test to determine statistical significance (P < 0.05). Results: Epidural analgesia was associated with maternal fever (odds ratio = 4.0; 95% confidence interval = 2.0-7.7), as was nulliparity (odds ratio = 4.1; 95% confidence interval = 1.8-9.1) and labor longer than 12 h (odds ratio = 5.4; 95% confidence interval = 2.9-9.9). These factors were all independent variables for maternal fever when analyzed using logistic regression. Conclusions: Epidural analgesia is associated with maternal fever. However, nulliparity and dysfunctional labor are also significant cofactors in the fever attributed to epidural analgesia.

Original languageEnglish (US)
Pages (from-to)1271-1275
Number of pages5
JournalAnesthesiology
Volume90
Issue number5
DOIs
StatePublished - May 1 1999

Keywords

  • Epidural analgesia
  • Maternal fever
  • Neonatal sepsis evaluations

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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