Clinical Study Of The Effect Of Epidural Labor Analgesia And Intrapartum Fever During Labor On Maternal And Infant Outcomes

Objectives:To clarify the relationship between epidural labor analgesia and intrapartum fever,investigate the effects of epidural labor analgesia and intrapartum fever during analgesia on the labor process and maternal and infant outcomes,to analyze the factors that influence intrapartum fever during epidural labor analgesia.Methods:Four hundred and seventy-five women who underwent a vaginal trial of labor at the Obstetrics Department of the Affiliated Hospital of Guilin Medical College from September 1,2020,to December 31,2020,were selected as the study population.The women who received epidural labor analgesia were classified as the analgesic group(277 cases).The women who did not receive epidural labor analgesia were ranked as the non-analgesic group(198 cases).In the analgesic group,the women were divided into the analgesic fever group(42cases)and the analgesic no fever group(235 cases)according to whether their maximum body temperature was ≥38°C during labor.The primary conditions,delivery,analgesia,neonatal condition and laboratory test results of each group were compared to clarify the relationship between epidural labor analgesia and intrapartum fever,to investigate the effects of epidural labor analgesia and intrapartum fever during analgesia on labor process and maternal and infant outcomes,and to explore the influencing factors related to intrapartum fever during epidural labor analgesia by binary logistic regression analysis.Results:1.The labor and delivery analgesia group had a higher rate of intrapartum fever and use of indocin than the non-analgesia group(P<0.05),and the first,second and total duration of labor was longer than the non-analgesia group(P<0.05).The two groups had no statistical difference in the cesarean delivery rate,assisted delivery rate,postpartum bleeding,neonatal birth score and transfer rate(P<0.05).2.The incidence of amniotic fluid-fecal contamination,cesarean section,contractions and chorioamnionitis were higher in the analgesic-fever group than in the analgesic-no-fever group(P<0.05),and the duration of the first,second and total labor and the time from analgesia to delivery were more extended than in the analgesic-no-fever group(P<0.05).3.Logistic regression analysis showed that length of labor(OR=1.152,95%CI: 1.022-1.300),number of vaginal examinations(OR=1.280,95% CI:1.042-1.572),and contamination with amniotic fluid and feces(OR=4.089,95%CI: 1.323-12.638),BMI(body mass index)(OR=1.151,95% CI: 1.001-1.324)were all factors associated with fever during epidural labor analgesia.(body mass index)(OR=1.151,95% CI: 1.001～1.324)were all relevant influencing factors for intrapartum fever during epidural labor analgesia.Conclusions:1.Epidural labor analgesia may increase the risk of intrapartum fever and prolonged labor.However,it has no significant effect on the mode of delivery or adverse maternal and neonatal outcomes,and women can make informed choices based on their needs.2.Intrapartum fever during epidural labor analgesia increases the risk of prolonged labor,amniotic fluid and fecal contamination,postpartum hemorrhage,cesarean delivery,and chorioamnionitis.It may also increase the rate of neonatal transfer,and intrapartum fever during analgesia should be actively managed to reduce the occurrence of adverse maternal and infant outcomes.3.The factors associated with lintrapartum fever during epidural labor analgesia include the length of labor,number of vaginal examinations,amniotic fluid and fecal contamination,and BMI.To address these factors,the risk of labor fever during epidural labor analgesia was reduced by minimizing the length of labor,reducing the number of vaginal examinations,and controlling maternal BMI.