Risk of Neonatal Short-Term Adverse Outcomes Associated with Noninfectious Intrapartum Hyperthermia: A Nested Case-Control Retrospective Study

Abstract

Objective Aim of this study was to identify risk factors for adverse neonatal outcomes in neonates born to mothers with noninfectious intrapartum hyperthermia. Study Design A retrospective study was conducted of 460 singleton deliveries diagnosed with noninfectious intrapartum hyperthermia. Logistic regression was used to estimate the association between ante- and intrapartum risk factors and neonatal outcomes. Results The 460 singleton pregnant women were 19 to 43 years of age. They developed an intrapartum temperature of ≥37.5°C somewhere between 340/7 to 414/7 weeks' gestation; 437 (95%) were nulliparous. Meconium-stained amniotic fluid was associated with positive pressure ventilation or intubation ventilation (odds ratio [OR] = 5.940, 95% confidence interval [CI]: 2.038–17.318), birth depression (OR = 6.288, 95% CI: 2.273–17.399), and wet lung (OR = 2.747, 95% CI: 1.322–5.709). Induction of labor with artificial rupture of membranes (AROM; OR = 2.632, 95% CI: 1.325–5.228) was associated with neonatal infections. Maternal temperature ≥ 38°C was associated with neonate's artery blood gas pH < 7.3 (OR = 2.366, 95%CI: 1.067–5.246) and wet lung (OR = 2.909, 95% CI: 1.515–5.586). Maternal elevated C-reactive protein (CRP) was associated with neonatal infections (OR = 1.993, 95% CI: 1.260–3.154) and wet lung (OR = 2.600, 95% CI: 1.306–5.178). Conclusion Meconium-stained amniotic fluid, induction of labor, maternal temperature ≥ 38°C, and elevated CRP during labor were risk factors for adverse neonatal outcomes.