Severity of Intrapartum Fever and Neonatal Outcomes

Abstract

(Am J Obstet Gynecol. 2022;227:513.e1–513.e8) Infection- or noninfection-mediated intrapartum maternal fever (≥38 °C) is a frequent complication of childbirth, affecting 1 in 15 deliveries. Associations with increased risk for neonatal morbidity include low Apgar score, sepsis, encephalopathy, seizures, respiratory distress, meconium aspiration, and NICU admission. Risk for maternal morbidity as defined by labor dystocia, hemorrhage, instrumental vaginal delivery, and cesarean delivery is also heightened. Studies investigating the correlation of fever severity to increased neonatal and maternal morbidity are conflicting and have been conducted in homogenous patient populations with labor management differing from the standard of care in the United States. The aim of this study was to evaluate the relationship between increased severity of intrapartum fever and maternal and neonatal morbidity in a diverse, contemporary cohort, and medical practice. The authors hypothesized that risk would be independent from the duration of the time from the maximum fever temperature (Tmax) through to delivery.