Maternal intrapartum temperature elevation as a risk factor for cesarean delivery and assisted vaginal delivery

Objectives. This study investigated the association of intrapartum temperat ure elevation with cesarean delivery and assisted vaginal delivery. Methods. Participants were 1233 nulliparous women with singleton, term preg nancies in vertex presentations who had spontaneous labors and were afebril e (temperature; 99.5 degrees F [37.5 degrees C]) at admission for delivery. Rates of cesarean and assisted vaginal deliveries according to highest int rapartum temperature were examined by epidural status. Results. Women with maximum intrapartum temperatures higher than 99.5 degre es F were 3 times as likely to experience cesarean (25.2% vs 7.2%) or assis ted vaginal delivery (25.2% vs 8.5%). The association was present in epidur al users and nonusers and persisted after birthweight, epidural use, and la bor length had been controlled. In adjusted analyses, temperature elevation was associated with a doubling in the risk of cesarean delivery (odds rati o [OR] = 2.3, 95% confidence interval [CI] = 1.5, 3.4) and assisted vaginal delivery (OR = 2.1, 95% CI = 1.4, 3.1). Conclusions. Modest temperature elevation developing during labor was assoc iated with higher rates of cesarean and assisted vaginal deliveries. More f requent temperature elevation among women with epidural analgesia may expla in in part the higher rates of cesarean and assisted vaginal deliveries obs erved with epidural use.