MATERNAL FEVER IN TERM LABOR IN RELATION TO FETAL TACHYCARDIA, CORD ARTERY ACIDEMIA AND NEONATAL INFECTION

Objective To determine 1. whether maternal fever during term labour is associated with acidaemia at birth and neonatal infection and 2. whet her fetal tachycardia precedes maternal fever and is associated with n eonatal infection Design Retrospective matched-pair case-control study . Subjects Two hundred and forty-eight newborn infants whose mothers d eveloped fever during term labour (cases) and 248 control infants. The women were matched for parity and duration of labour. Main outcome me asures Cord artery acid-base status, Apgar scores, neonatal infections , and fetal heart rate before maternal fever. Results Mean pH, as well as the rate of cord artery acidaemia at birth (pH < 7.10) was equal i n cases and controls (in both groups 7.24% and 6%, respectively). Sign s of septicaemia and/or pneumonia were identified in 17 case newborns (7%) and in one control (0.4%; OR 17.0, P < 0.001). Of 212 pairs with complete heart rate data, fetal tachycardia preceded maternal fever in 39 cases (18%) and in 16 controls (8%) (OR 2.6, P = 0.003). Tachycard ia before maternal fever was not associated with increased neonatal in fectious morbidity. Conclusions Maternal fever during term labour was associated with perinatal infection, but not with acidaemia at birth. Elevated fetal heart rate preceded maternal fever in a minority of cas es and was not associated with perinatal infection.