The Association of Maternal Intrapartum Subfebrile Temperature and Adverse Obstetric and Neonatal Outcomes

Authors

  • Uri P. Dior,

    Corresponding author
    1. Department of Obstetrics and Gynecology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
    2. Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
    • Correspondence:

      Uri P. Dior, Department of Obstetrics and Gynecology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, P.O. Box 12000, Jerusalem 91120, Israel.

      E-mail: uri.dior@gmail.com

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    • First and second authors contributed equally to this study.
  • Liron Kogan,

    1. Department of Obstetrics and Gynecology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
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    • First and second authors contributed equally to this study.
  • Ronit Calderon-Margalit,

    1. Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
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  • Ayala Burger,

    1. Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
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  • Hagai Amsallem,

    1. Department of Obstetrics and Gynecology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
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  • Uriel Elchalal,

    1. Department of Obstetrics and Gynecology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
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  • Smadar Eventov-Friedman,

    1. Department of Neonatology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
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  • Zivanit Ergaz,

    1. Department of Neonatology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
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  • Yossef Ezra

    1. Department of Obstetrics and Gynecology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
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  • Presentation Information: This study was presented in part at the 32nd Annual Meeting of the Society for Maternal-Fetal Medicine, 6–11 February 2012, Dallas, Texas.

Abstract

Background

Subfebrile intrapartum maternal temperature is very common, yet there is sparse evidence regarding its causes or its effects on perinatal outcomes. We examined whether mild temperature elevation during labour is a risk marker for adverse obstetric and neonatal outcomes.

Methods

A retrospective cohort analysis including 42 601 term, singleton live-births in two medical centres between 2003 and 2010 was performed. This study compared women who experienced a maximal intrapartum temperature of ≤37°C with women who experienced subfebrile intrapartum temperature (37.1–37.9°C). Adjusted risks for adverse obstetric and neonatal outcomes were calculated by using multivariable logistic regression models.

Results

Compared with maternal temperature ≤ 37°C, subfebrile temperature was associated with higher rates of primary caesarean deliveries {adjusted odds ratios [aOR] = 1.36 [95% confidence interval (CI) 1.25, 1.49])} and assisted vaginal deliveries (aOR = 1.20 [95% CI 1.11, 1.30]), as well as with greater risks of early neonatal sepsis (aOR = 2.66 [95% CI 1.88, 3.77]), neonatal intensive care unit admissions (aOR = 1.40 [95% CI 1.08, 1.83]), and neonatal asphyxia or seizures (aOR = 3.18 [95% CI 1.51, 6.70]). Mildly elevated maternal intrapartum temperature (37.1–37.5°C) was also associated with adverse outcomes.

Conclusions

Maternal intrapartum subfebrile temperature may be an indicator of operative delivery and neonatal morbidity. Further research is needed to confirm these findings and to reveal underlying mechanisms.

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