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. 2024 Jul;310(1):195-202.
doi: 10.1007/s00404-024-07564-5. Epub 2024 May 26.

Intrapartum fever complicated with maternal bacteremia: prevalence, bacteriology, and risk factors

Emmanuel Attali  1   2 , Guy Kern  3 , Miriam Warshaviak  4   3 , Lee Reicher  4   3 , Ariel Many  3 , Yariv Yogev  4   3 , Yuval Fouks  4   3   5
Affiliations

Intrapartum fever complicated with maternal bacteremia: prevalence, bacteriology, and risk factors

Emmanuel Attali et al. Arch Gynecol Obstet. 2024 Jul.

Abstract

Purpose: To assess the prevalence, microbial profile, and clinical risk factors of maternal bacteremia associated with intrapartum fever (IPF).

Methods: A retrospective cohort study, in a single tertiary university-affiliated medical center between 2012 and 2018. Demographic and labor characteristics of women, who delivered at term (37+0/7-41+6/7) and developed bacteremia following IPF were compared to a control group of women with IPF but without bacteremia.

Results: During the study period there were 86,590 deliveries in our center. Of them, 2074 women (2.4%) were diagnosed with IPF, of them, for 2052 women (98.93%) the blood maternal cultures were available. In 26 patients (1.25%) maternal bacteremia was diagnosed. A lower rate of epidural anesthesia (84.6% vs 95.9%, p = 0.02) and a higher rate of antibiotics prophylaxis treatment prior to the onset of fever (30.8%.vs 12.1%, p = 0.006) were observed in patients who developed maternal bacteremia in comparison to those who have not. Maternal hyperpyrexia developed after initiation of antibiotics or without epidural anesthesia remained significantly associated with maternal bacteremia after applying a multivariate analysis, (Odds Ratio 3.14 95% CI 1.27-7.14, p = 0.009; 4.76 95% CI 1.35-12.5, p = 0.006; respectively).

Conclusion: Maternal fever developing after initiation of antibiotics or without epidural is associated with maternal bacteremia.

Keywords: Antibiotics; Bacteremia; Intrapartum fever.

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Conflict of interest statement

All authors report no conflict of interest.

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