The association between epidural labor analgesia and maternal fever

The association between epidural labor analgesia and maternal fever is complex and controversial. Observational, retrospective, before-and-after, and randomized controlled trials all support the association, with the most current evidence supporting the mechanistic involvement of noninfectious infla...

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Bibliographic Details
Published inClinics in perinatology Vol. 40; no. 3; p. 385
Main Authors Arendt, Katherine W, Segal, B Scott
Format Journal Article
LanguageEnglish
Published United States 01.09.2013
Subjects
Analgesia, Epidural - statistics & numerical data
Analgesia, Obstetrical - statistics & numerical data
Anti-Bacterial Agents - therapeutic use
Cesarean Section - utilization
Female
Fever - epidemiology
Humans
Labor Pain - drug therapy
Obstetric Labor Complications - epidemiology
Pregnancy
Risk Factors
Maternal temperature
Labor
Epidural analgesia
Hyperthermia
Intrapartum fever
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Summary:The association between epidural labor analgesia and maternal fever is complex and controversial. Observational, retrospective, before-and-after, and randomized controlled trials all support the association, with the most current evidence supporting the mechanistic involvement of noninfectious inflammation. Considering the clinically significant neonatal consequences that have been previously demonstrated, and the possibility of more common subclinical fetal brain injury that animal models imply, the avoidance of maternal fever during labor is imperative. With the current popularity of epidural analgesia in labor, it is important that clinicians delineate how epidurals cause maternal fever and how to block the noninfectious inflammatory response that seems to warm a subset of women laboring with epidurals.
ISSN:1557-9840
DOI:10.1016/j.clp.2013.06.002