• Charalampos Agakidis, Eleni Agakidou, Sumesh Philip Thomas, Prashanth Murthy, and David John Lloyd.
• Neonatal Unit, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen AB25 2ZL, Scotland, UK. cagakidis@hotmail.com
• J. Matern. Fetal. Neonatal. Med. 2011 Sep 1;24(9):1128-32.

ObjectiveTo explore whether epidural analgesia (EA) in labor is independent risk factor for neonatal pyrexia after controlling for intrapartum pyrexia.MethodsRetrospective observational study of 480 consecutive term singleton infants born to mothers who received EA in labor (EA group) and 480 term infants delivered to mothers who did not receive EA (NEA group).ResultsMothers in the EA group had significantly higher incidence of intrapartum pyrexia [54/480 (11%) vs. 4/480 (0.8%), OR = 15.1, p < 0.0001] and neonatal pyrexia [68/480 (14.2%) vs. 15/480 (3.1%), OR = 5.1, p < 0.0001]. Neonates in the EA group had a median duration of pyrexia of 1 h (maximum 5 h) with a peak temperature within 1 h. Stepwise logistic regression analysis showed that maternal EA was independent risk factor for neonatal pyrexia (>37.5°C) after controlling for intrapartum pyrexia (>37.9°C) and other confounders (OR = 3.44, CI = 1.9-6.3, p < 0.0001). Sepsis work-up was performed significantly more frequently in infants in the EA group [11.7% vs. 2.5%, OR= 5.2, CI = 2.7-9.7, p < 0.0001] with negative blood cultures.ConclusionsEA in labor is an independent risk factor for pyrexia in term neonates. It is unnecessary to investigate febrile offspring of mothers who have had epidurals unless pyrexia persists for longer than 5 h or other signs or risk factors for neonatal sepsis are present.

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