Women who receive epidural analgesia during labor are more likely to develop fever than those who do not. Maternal fever during labor can produce various harmful effects on both mothers and infants. The investigators speculate that the effect of epidural analgesia is associated with the development of maternal fever, i.e., better analgesia is associated with higher risk of maternal fever.
Epidural related maternal fever (ERMF) refers to the phenomenon of increased body temperature of parturient after receiving epidural analgesia during labor. Women who receive epidural labor analgesia are more likely to have fever than those who do not. In a systematic review, 20-33% of parturients receiving neuraxial analgesia developed fever during labor, compared with only 5-7% of those without neuraxial analgesia. Maternal fever can interfere with women's laboring process, decrease the sensitivity of the uterus and cervix to oxytocin, and lead to dystocia and increased surgical delivery rate. The investigators note that the rate of ERMF is lower in patients receiving lower density neuraxial blockade. The study is designed to test the hypothesis that the effect of epidural analgesia is associated with the development of maternal fever, i.e., better analgesia is associated with higher risk of maternal fever.
Study Type
OBSERVATIONAL
Enrollment
1,051
Epidural analgesia is performed with a mixture of local anesthetics (ropivacaine) and opioids (sufentanil).
Peking University First Hospital
Beijing, Beijing Municipality, China
Xiamen maternal and child hospital
Xiamen, Fujian, China
Dongguan women and children's hospital
Dongguan, Guangdong, China
Guangzhou Women and Children's Medical Center
Guangzhou, Guangdong, China
Occurrence of maternal fever during labor
Maternal fever is defined as temperature of ≥38℃ during any stage of labor.
Time frame: delivery ( the end of childbirth.)
Occurrence of mild maternal fever during labor
Mild maternal fever is defined as temperature of \>37.5℃ during any stage of labor.
Time frame: delivery ( the end of childbirth.)
Duration of labor
Duration of the first, second, and third stage of labor.
Time frame: delivery ( the end of childbirth.)
Neonatal Apgar score
Apgar score is assessed at 1 and 5 minutes after birth.
Time frame: At 1 and 5 minutes after birth.
Postpartum hospital stay
Postpartum hospital stay
Time frame: Up to 42 days after childbirth.
Postpartum pain intensity
Pain intensity is assessed with numeric rating scale (NRS; an 11-point scale where 0=no pain and 10=the worst pain).
Time frame: At 1, 10 and 42 days after childbirth
Postpartum breastfeeding
The status of breastfeeding include breastfeeding, formula milk, or a mix of them.
Time frame: At 1, 10 and 42 days after childbirth
Postpartum persistent pain
Defined as NRS pain score ≥1 that persisted since childbirth. For those with persistent pain, also ask if the following activities was affected, including walking, mood, sleep or concentration, as judged by parturients themselves.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Shijiazhuang Obstetric and Gynecology Hospital
Shijiazhuang, Hebei, China
Tangshan maternal and child hospital
Tangshan, Hebei, China
Beijing Fuxing Hospital
Beijing, China
Beijing Haidian women and children's Hospital
Beijing, China
Time frame: At 42 days after childbirth
Postpartum depression score
Postpartum depression is assessed with the the Edinburgh Postnatal Depression Scale. This is a 10-item self-report questionnaire; each item is rated from 0 to 3 denoting the increasing severity of symptoms, resulting in a maximum score of 30. A score ≥10 is defined as the presence of depression.
Time frame: At 10 and 42 days postpartum
Postpartum complications
Include maternal and neonatal complications, indicate new onset medical events that are harmful and required therapeutic intervention.
Time frame: Up to 42 days postpartum