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Obstetric Anesthesia
Anesthesia and Pain Medicine 2014;9(1):61-64.
Published online January 30, 2014.
The effects of epidural analgesia on maternal fever and neonatal outcomes
Joo Yeon Jeon, Hea Jo Yoon, In Ho Lee, Young Seok Jee, Pil Moo Lee
Department of Anesthesiology and Pain Medicine, Cheil General Hospital, Kwandong University Medical School, Seoul, Korea.
Received: 22 July 2013   • Revised: 2 September 2013
In low-risk women at term, epidemiologic studies have shown that fever in nulliparous parturients during labor is related to epidural use. Moreover, effects of fever associated with epidural analgesia on adverse neonatal outcomes have been debated. The purpose of this study is to evaluate the influence of epidural analgesia on intrapartum fever, neonatal outcomes in deliveries including nulliparity and multiparity.
We retrospectively investigated normal full-term spontaneous deliveries during 2012. Of 3,858 mother-infant pairs, 3,179 (82%) parturients received and 679 (18%) parturients did not receive epidural analgesia during labor. We regarded intrapartum fever greater than 37.5degrees C, and the parturients with fever were treated with intravenous propacetamol. We divided the study population according to labor epidural analgesia use and, fever and compared the incidence of fever and neonatal outcomes.
Incidence of fever was higher in the epidural group compared with the no epidural group (21 vs. 5%). The number of babies with a 1 min Apgar < 7 was lower in the no epidural with no fever group, and neonatal seizure was more frequent in the epidural with fever group compared with the no epidural without fever group, no epidural with fever group, and the epidural without fever group.
Incidence of fever was increased in the epidural analgesia group. Adverse neonatal outcomes were more frequent in the epidural with fever group. No conclusion whether the epidural analgesia cause neonatal adverse outcomes can be drawn due to confounding factors.
Key Words: Apgar score, Epidural analgesia, Intrapartum fever, Neonatal seizure

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