Intrapartum Temperature Elevation, Epidural Use, and Adverse Outcome in Term Infants

Abstract

The proportion of infants experiencing adverse outcomes increased with the degree of epidural-related maternal temperature elevation. Epidural use without temperature elevation was not associated with any of the adverse outcomes we studied.

Retrospective study of the association between epidural analgesia during labour and complications for the newborn

“…The association found in our cohort may be related to the increased risk of fever and possible sepsis that has been observed in mothers receiving epidural anaesthesia and in their newborn (Mercer et al, 2007;Greenwell et al, 2012). Other alterations that have been associated with exposure to epidural analgesia, including respiratory depression, may also play a role (Poole, 2003;Mercer et al, 2007).…”

“…These have been associated with an increased heart rate and altered Apgar index and encephalopathy index values in the newborn and with convulsions during the neonatal period (Leighton and Halpern, 2002;Reynolds, 2010 However, published data on the impact of epidural analgesia have been contradictory, and this issue remains controversial among the healthcare professionals involved. Thus, some studies associated epidural analgesia with a reduced Apgar index or a delay in the early initiation of breast feeding, whereas others found no differences (Anim-Somuah et al, 2011;Greenwell et al, 2012;Jones et al, 2012).…”

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

“…Epidural analgesia is associated with intrapartum fever [7,8,9,10] and was shown to be associated with adverse neonatal [11] and maternal outcomes such as lower umbilical arterial pH and increased rate of instrumental delivery [12]. Prolonged labor is linked with intrapartum fever [13], as well as with adverse neonatal [4,5,6] and maternal outcomes [6,14,15].…”

“…Impey et al [17,18] demonstrated that intrapartum fever is associated with an almost 5-fold risk for neonatal encephalopathy and a 3.4-fold increase in the risk of unexplained neonatal seizures [17]. In a small retrospective study, neonates of febrile parturients had increased risk of low Apgar scores, seizures, hypotonia, and need for assisted ventilation [11]. …”

La fiebre intraparto como factor predictivo de parto distócico y resultado neonatal adverso

“…La causa más frecuente de fiebre intraparto es el uso de la anestesia epidural que es una fiebre no infecciosa [1][2][3][4][5][6][7][8][9] . Existen también otros factores de riesgo clásicos, como la primiparidad, trabajo de parto prolongado, rotura de membranas prolongada, colonización por estreptococo del grupo B. .…”