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

• Published in: Archives of gynecology and obstetrics 2024-07, Vol.310 (1), p.195-202
• Main Authors: Attali, Emmanuel, Kern, Guy, Warshaviak, Miriam, Reicher, Lee, Many, Ariel, Yogev, Yariv, Fouks, Yuval
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia, Epidural - adverse effects; Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis; Antibiotics; Bacteremia - epidemiology; Bacteremia - microbiology; Endocrinology; Epidural; Female; Fever - epidemiology; Fever - etiology; Fever - microbiology; Gynecology; Human Genetics; Humans; Maternal-Fetal Medicine; Medicine; Medicine & Public Health; Obstetric Labor Complications - epidemiology; Obstetric Labor Complications - microbiology; Obstetrics/Perinatology/Midwifery; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - microbiology; Prevalence; Retrospective Studies; Risk Factors
• ISSN: 1432-0711; 0932-0067; 1432-0711
• DOI: 10.1007/s00404-024-07564-5

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.