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Maternal fever during labor is a strong predictor of infection-related neonatal and infant death

When a mother has a fever during labor, it is usually a sign of inflammation of the fetal membranes due to infection. This fever is strongly associated with infection-related neonatal and infant deaths among both preterm and term infants, according to a study supported in part by the Agency for Healthcare Research and Quality (HS09788).

Researchers from the University of Medicine and Dentistry of New Jersey and the Robert Wood Johnson Medical School retrospectively analyzed the association of intrapartum fever with neonatal and infant death among more than 11 million single live births in the United States during the period 1995-1997. They used linked birth and infant death data from the National Center for Health Statistics.

Nearly 2 percent (1.6 percent) of mothers had intrapartum fever (100.2 degrees F or higher). Intrapartum fever was associated with increased risk for early neonatal (0-6 days) death among both preterm and term infants, and infant (up to 1 year of age) death among mothers having their first babies. Among preterm infants of mothers who had previously given birth, intrapartum maternal fever increased the risk by 30 percent for early neonatal death, after adjustment for important confounding factors, ranging from maternal age and race to pregnancy and labor complications.

When considering both first-time mothers and those who had given birth before, intrapartum fever was a strong predictor of infection-related death. Among term infants, intrapartum fever tripled the risk of early neonatal death and nearly doubled the risk for infant death. Intrapartum fever also increased the risk of early neonatal and infant death among preterm infants. Intrapartum fever was associated with meconium aspiration syndrome, hyaline membrane disease that causes respiratory distress, neonatal seizures, and newborn need for assisted ventilation among both term and preterm infants.

More details are in "Association of maternal fever during labor with neonatal and infant morbidity and mortality," by Anna Petrova, M.D., Ph.D., Kitaw Demissie, M.D., Ph.D., George G. Rhoads, M.D., M.P.H., and others, in the July 2001 Obstetrics and Gynecology 98, pp. 20-27.

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