RISK-FACTORS FOR FEVER IN LABOR

Objective: To identify risk factors for fever in labor. Methods: A ret rospective case-control study was conducted. Maternal sublingual tempe rature was measured every 2-4 hours during labor in 3109 of 3860 conse cutive term parturients presenting from September 1992 through Decembe r 1993. Women who had fever (at least one recorded temperature of 38C or more, n = 72) during labor were compared with those who remained af ebrile (n = 3037). Furthermore, a matched-pair case-control study was conducted, involving 250 women at term who developed fever in labor an d 250 controls matched for parity and duration of labor; all delivered between January 1989 and December 1993. A conditional multiple logist ic regression analysis was used to identify independent risk factors f or fever during labor. Results: In the case-control study, fever was a ssociated with epidural analgesia, nulliparity, and a long duration of labor. These three variables were also related among themselves. Howe ver, multiple regression analysis showed that all three variables were independently associated with maternal temperature. In the matched-pa ir study, epidural analgesia, rupture of membranes longer than 24 hour s, latency phase exceeding 8 hours, and a temperature in the upper nor mal range (37.5-37.9C) at admission were independent risk factors for developing fever in labor. Conclusion: Epidural analgesia, duration of labor, and a long interval from rupture of membranes to delivery were independent risk factors for maternal fever in labor.