Risk Factors of Combined Spinal Epidural Analgesia on Maternal Intrapartum Fever

Abstract

Abstract Objective Combined spinal epidural analgesia (CSEA) has been commonly used as clinical labor anesthesia. Intrapartum fever induced by CSEA frequently occurs and seriously endangers maternal and fetal health. The aim of this study is to explore the risk factors of CSEA on maternal intrapartum fever. Methods A total of 200 parturient women from Suzhou Municipal Hospital were included in this study.74 parturient women with intrapartum fever during combined spinal epidural analgesia were included in fever group and 126 parturient women with normal body temperature in control group. The maternal demographic characteristics, details of labor and delivery, anesthetic scheme, fetal weight and Apgar score were collected. Logistic regression and receiver operating characteristic (ROC) curve were used to analyze the related factors of intrapartum fever during labor analgesia. Nomogram and decision curve analysis (DCA) were used to apply and evaluate the predictive model. Results Logistic multivariate analysis indicated that the times of vaginal examinations (OR 2.069,95%CI 1.587–2.696), duration of analgesia (OR 2.466,95%CI 1.741–3.492), time from rupture of membrane to delivery (OR 0.909,95%CI 0.855–0.967) and labor induced by water sac(OR 10.806,95%CI 1.384–84.035)were independent risk factors for intrapartum fever. More than 7 times of vaginal examinations, 3.35h of CSEA and 5.26h from rupture of membrane to delivery prompt for higher risk of maternal intrapartum fever. Conclusion The times of vaginal examinations, duration of analgesia, time from rupture of membrane to delivery and water sac induced labor are identified as risk factors of CESA-induced intrapartum fever. The predictive model and the nomogram based on the above risk factors contribute to evaluate and restraint intrapartum fever during labor anesthesia.