The effect of intrapartum maternal fever on neonatal outcomes: a systematic review and meta-analysis.

IF 2 3区医学 Q2 PEDIATRICS

Frontiers in Pediatrics Pub Date : 2025-09-17 eCollection Date: 2025-01-01 DOI:10.3389/fped.2025.1571732

Qian Ling, Haixia Wan

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引用次数: 0

Abstract

Objective: To systematically review the link between intrapartum maternal fever and adverse neonatal outcomes in term singleton pregnancies not complicated by chorioamnionitis.

Methods: The PubMed, Web of Science, Scopus, and Embase databases were searched for studies published up to June 30, 2024, that reported data on women with term singleton pregnancies and intrapartum fever. Studies describing cases of chorioamnionitis (CAM) were excluded. The included studies had to have defined exclusion criteria to ensure that women with a high likelihood of CAM were excluded. Neonatal outcomes of interest were infection/sepsis, fetal distress, assisted ventilation, low APGAR scores, neonatal intensive care unit (NICU) admission, seizures, and hypotonia. Study quality was assessed by the Newcastle-Ottawa Scale (NOS). A random-effects model was used to pool effect sizes, which were reported as odds ratios (OR) and weighted mean differences (WMD). Funnel plots and Egger's test were used to assess publication bias.

Results: A total of 11 studies (n = 153,410) were included. Neonates born to mothers with intrapartum fever had a higher risk of low APGAR scores (OR 2.97, 95% CI: 1.61, 5.48), need for assisted ventilation (OR 2.50, 95% CI: 1.59, 3.93), infection/sepsis (OR 6.01, 95% CI: 2.68, 13.5), NICU admission (OR 2.77, 95% CI: 1.40, 5.51), seizures (OR 4.25, 95% CI: 1.95, 9.22), and hypotonia (OR 4.19, 95% CI: 1.72, 10.2). The birth weight of neonates delivered by febrile mothers was significantly higher (WMD 63.4 g, 95% CI: 16.2, 110.5). Publication bias was noted for low APGAR scores and neonatal infection/sepsis.

Conclusion: Intrapartum maternal fever appears to be associated with increased risks of adverse neonatal outcomes. However, the challenge of entirely excluding CAM-related fever and variability in study methodologies limits the robustness of the findings. Nonetheless, proactive management of maternal fever during labor could be critical.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024565830, PROSPERO CRD42024565830.

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产时产妇发热对新生儿结局的影响：一项系统回顾和荟萃分析。

目的：系统回顾未合并绒毛膜羊膜炎的足月单胎妊娠产时产妇发热与新生儿不良结局的关系。方法：检索PubMed、Web of Science、Scopus和Embase数据库，检索截至2024年6月30日发表的关于足月单胎妊娠和产时发热妇女的研究。排除了绒毛膜羊膜炎（CAM）病例的研究。纳入的研究必须有明确的排除标准，以确保排除极有可能发生CAM的妇女。新生儿结局感兴趣的是感染/败血症，胎儿窘迫，辅助通气，低APGAR评分，新生儿重症监护病房（NICU）入院，癫痫发作和张力低下。研究质量采用纽卡斯尔-渥太华量表（NOS）进行评估。随机效应模型用于汇总效应大小，以比值比（OR）和加权平均差异（WMD）报告。采用漏斗图和Egger检验评估发表偏倚。结果：共纳入11项研究（n = 153410）。产时发热母亲所生的新生儿APGAR评分较低（OR 2.97, 95% CI: 1.61, 5.48）、需要辅助通气（OR 2.50, 95% CI: 1.59, 3.93）、感染/败血症（OR 6.01, 95% CI: 2.68, 13.5）、新生儿重症监护病房入院（OR 2.77, 95% CI: 1.40, 5.51）、癫痫发作（OR 4.25, 95% CI: 1.95, 9.22）和肌无力（OR 4.19, 95% CI: 1.72, 10.2）的风险较高。发热母亲分娩的新生儿出生体重明显较高（WMD为63.4 g, 95% CI: 16.2, 110.5）。低APGAR评分和新生儿感染/败血症存在发表偏倚。结论：产时产妇发热似乎与新生儿不良结局的风险增加有关。然而，完全排除cam相关发热和研究方法的可变性的挑战限制了研究结果的稳健性。尽管如此，对分娩期间产妇发热的积极管理可能是至关重要的。系统评价注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD42024565830, PROSPERO CRD42024565830。

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来源期刊

Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

3.60

自引率

7.70%

发文量

2132

审稿时长

14 weeks

期刊介绍： Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.