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ORIGINAL RESEARCH |
From the Departments of Family Medicine, Environmental and Community Medicine, and Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology and Reproductive Sciences, University of Medicine and Dentistry of New Jersey (UMDNJ)—Robert Wood Johnson Medical School (RWJMS), Piscataway, New Jersey.
Address reprint requests to: Kitaw Demissie, MD, PhD, Department of Environmental and Community Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 675 Hoes Lane, Piscataway, NJ 08854-5635; E-mail: demisski{at}umdnj.edu
OBJECTIVE: To examine the association of intrapartum fever with infant morbidity and early neonatal (0–6 days) and infant (0–364 days) death.
METHODS: We carried out a retrospective cohort analysis among singleton live births in the United States for the period 1995–1997 using the National Center for Health Statistics linked birth-infant death cohort data.
RESULTS: Among the 11,246,042 singleton live births during the study period, intrapartum fever (at least 38C) was recorded in 1.6%. Intrapartum fever was associated with early neonatal (adjusted odds ratio [OR], 95% confidence interval [CI] for preterm and term infants respectively: 1.32; 1.11, 1.56 and 1.67; 1.14, 2.46) and infant (OR, 95% CI for preterm and term, respectively: 1.31; 1.14, 1.51 and 1.27; 1.01, 1.59) death among nulliparous mothers. Among preterm infants of parous mothers, intrapartum fever was associated with early neonatal (OR 1.29, 95% CI 1.01, 1.64) death. In the combined analyses (infants of nulliparous and parous mothers), intrapartum fever was a strong predictor of infection-related death. These associations were stronger among term (OR 3.16, 95% CI 1.56, 6.40 for early neonatal; OR 1.75, 95% CI 1.20, 2.57 for infant death) than preterm infants (OR 1.52, 95% CI 1.15, 2.00 for early neonatal; OR 1.29, 95% CI 1.05, 1.57 for infant death). Intrapartum fever was also a risk factor for meconium aspiration syndrome, hyaline membrane disease, neonatal seizures, and assisted ventilation.
CONCLUSION: Intrapartum fever is an important predictor of neonatal morbidity and infection-related mortality.
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