Risk Factors for Intrapartum Fever in Term Gestations and Associated Maternal and Neonatal Sequelae

<b><i>Aim:</i></b> To determine factors associated with intrapartum fever and to examine associated maternal and neonatal outcomes. <b><i>Methods:</i></b> Retrospective study of patients between 36^0/7 and 42^0/7 gestational weeks who entered spontaneous or induced active labor and developed temperature ≥38°C; a similar group that did not develop fever were controls. Univariate and multivariate analyses were performed with <i>p</i> < 0.05 as significant. <b><i>Results:</i></b> Fifty-four febrile patients and 306 nonfebrile controls met inclusion criteria. Nulligravidity (45.8 vs. 77.8%, <i>p</i> < 0.001), length of first stage ≥720 min (OR 3.59, 95% CI 1.97-6.55, <i>p</i> < 0.001), length of second stage ≥120 min (OR 4.76, 95% CI 2.29-9.89, <i>p</i> < 0.001), membrane rupture ≥240 min (46.4 vs. 79.6%, <i>p</i> < 0.001), increasing number of vaginal exams (4 vs. 6, <i>p</i> < 0.001), oxytocin (44.8 vs. 63.0%, <i>p</i> = 0.014), and meperidine (14.7 vs. 35.2%, <i>p</i> < 0.001) were all associated with intrapartum fever. Associated morbidity included cesarean delivery (22.5 vs. 44.4%, <i>p</i> = 0.001), Apgar score <7 at 5 min (0.7 vs. 5.6%, <i>p</i> = 0.011), and neonatal intensive care unit admission (9.5 vs. 51.9%, <i>p</i> < 0.001). <b><i>Conclusion:</i></b> We have identified several noninfectious factors that are associated with intrapartum fever. Modification of risk factors may improve both maternal and neonatal outcomes.