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Obstet Gynecol. 2011 Mar;117(3):588-95. doi: 10.1097/AOG.0b013e31820b0503.

Association of epidural-related fever and noninfectious inflammation in term labor.

Author information

1
Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, Massachusetts 02114, USA. lriley@partners.org

Abstract

OBJECTIVE:

To investigate the role of infection and noninfectious inflammation in epidural analgesia-related fever.

METHODS:

This was an observational analysis of placental cultures and serum admission and postpartum cytokine levels obtained from 200 women at low risk recruited during the prenatal period.

RESULTS:

Women receiving labor epidural analgesia had fever develop more frequently (22.7% compared with 6% no epidural; P=.009) but were not more likely to have placental infection (4.7% epidural, 4.0% no epidural; P>.99). Infection was similar regardless of maternal fever (5.4% febrile, 4.3% afebrile; P=.7). Median admission interleukin (IL)-6 levels did not differ according to later epidural (3.2 pg/mL compared with 1.6 pg/mL no epidural; P=.2), but admission IL-6 levels greater than 11 pg/mL were associated with an increase in fever among epidural users (36.4% compared with 15.7% for 11 pg/mL or less; P=.008). At delivery, both febrile and afebrile women receiving epidural had higher IL-6 levels than women not receiving analgesia.

CONCLUSION:

Epidural-related fever is rarely attributable to infection but is associated with an inflammatory state.

PMID:
21343762
DOI:
10.1097/AOG.0b013e31820b0503
[Indexed for MEDLINE]

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