Neonatal sepsis is mediated by maternal fever in labour epidural analgesia. (November 2014)

• Record Type: Journal Article
• Authors: Wassen, M. M. L. H.; Winkens, B.; Dorssers, E. M. I.; Marcus, M. A.; Moonen, R. M. J.; Roumen, F. J. M. E.
• Is Part Of: Journal of obstetrics and gynaecology. Volume 34:Number 8(2014)
• Page Start: 679
• Page End: 683
• Publication Date: 2014-11
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618.05
• DOI: 10.3109/01443615.2014.925858
• Languages: English
• ISSNs: 0144-3615

Abstract

<abstract> <title>Abstract</title> <p>The association between neonatal sepsis and labour epidural analgesia (EA) was evaluated. In a retrospective matched case–control study, 453 women delivering with EA (EA group) were matched on parity with 453 women with deliveries without EA (non-EA group). Significantly more neonates born in the EA-group had fever ≥ 38.0°C (11.6% vs 1.8%, <italic>p</italic> &lt; 0.001) at birth. The overall incidence of neonatal sepsis, based on clinical symptoms and defined as proven (by a positive blood culture) or suspected (no positive blood culture), was significantly higher in the EA group (6.0% vs 2.2%; <italic>p</italic> = 0.002), but the incidence of proven neonatal sepsis alone was not (0.4% vs 0%; <italic>p</italic> = 0.250). EA turned out to be an independent risk factor for neonatal sepsis (adjusted OR 2.43, 95% CI 1.15–5.13; <italic>p</italic> = 0.020). However, in the EA group as well as the non-EA group, the incidence of neonatal sepsis was significantly higher in mothers with intrapartum fever compared with afebrile mothers (11.0% vs 2.9% in the EA group; <italic>p</italic> = 0.004; 8.2% vs 1.3% in the non-EA group; <italic>p</italic> = 0.006). Therefore we conclude, that the positive association between neonatal sepsis and labour EA is possibly mediated by maternal intrapartum fever.</p> </abstract>