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Obstetrics & Gynecology: November 1995
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Objective To identify risk factors for fever in labor.

Methods A retrospective case-control study was conducted. Maternal sublingual temperature was measured every 2–4 hours during labor in 3109 of 3860 consecutive term parturients presenting from September 1992 through December 1993. Women who had fever (at least one recorded temperature of 38C or more, n = 72) during labor were compared with those who remained afebrile (n = 3037). Furthermore, a matched-pair case-control study was conducted, involving 250 women at term who developed fever in labor and 250 controls matched for parity and duration of labor; all delivered between January 1989 and December 1993. A conditional multiple logistic regression analysis was used to identify independent risk factors for fever during labor.

Results In the case-control study, fever was associated with epidural analgesia, nulliparity, and a long duration of labor. These three variables were also related among themselves. However, multiple regression analysis showed that all three variables were independently associated with maternal temperature. In the matched-pair study, epidural analgesia, rupture of membranes longer than 24 hours, latency phase exceeding 8 hours, and a temperature in the upper normal 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.

Address reprint requests to: Andreas Herbst, MD, Department of Obstetrics and Gynecology, University Hospital, Lund S-221 85, Sweden

© 1995 The American College of Obstetricians and Gynecologists