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Association of Epidural-Related Fever and Noninfectious Inflammation in Term Labor

2011; Lippincott Williams & Wilkins; Volume: 117; Issue: 3 Linguagem: Inglês

10.1097/aog.0b013e31820b0503

1873-233X

Laura E. Riley, Ann C. Celi, Andrew B. Onderdonk, Drucilla J. Roberts, Lise C. Johnson, Lawrence C. Tsen, Lisa Leffert, May C. M. Pian-Smith, Linda J. Heffner, Susan Haas, Ellice Lieberman,

Pelvic floor disorders treatments

In Brief 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. LEVEL OF EVIDENCE: II At term, epidural-related fever is rarely attributable to infection but is associated with elevated interleukin-6 levels at admission.