Maternal Fever Associated With Continuous Spinal Versus Epidural Labor Analgesia: A Single-Center Retrospective Study

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Maternal Health

Background:

• Neuraxial labor analgesia is linked to maternal fever, but the cause remains unclear.
• Proposed mechanisms include infection, altered thermoregulation, and local anesthetic effects.
• Previous studies focused on epidural analgesia, lacking comparisons with continuous spinal analgesia.

Purpose of the Study:

• To compare the incidence of intrapartum maternal fever between continuous spinal and epidural labor analgesia.
• To investigate potential differences in fever rates associated with these two neuraxial techniques.

Main Methods:

• Retrospective study comparing continuous spinal analgesia with matched epidural analgesia cases (June 2012-March 2020).
• Matched patients based on nulliparous status.
• Defined intrapartum maternal fever as temperature ≥38 °C before delivery; compared groups using Fisher exact test.

Main Results:

• 81 patients received continuous spinal analgesia, and 162 matched controls received epidural analgesia.
• Demographic and obstetric characteristics were similar between groups.
• Maternal fever incidence was 9.9% (continuous spinal) vs. 11.1% (epidural) (P = .83).

Conclusions:

• No significant difference in maternal fever rates between continuous spinal and epidural labor analgesia.
• Findings support altered thermoregulation from neuraxial blockade as a cause of fever.
• Further prospective studies are needed to elucidate the mechanisms of neuraxial analgesia-related maternal fever.