Abstract
Objective
Maternal peripartum fever can be caused by a number of infectious and non-infectious etiologies, and has been associated with the development of adverse maternal and neonatal outcome. Newborn consequences of maternal peripartum fever may include short-term complications such as sepsis, meningitis and pneumonia. Insufficient data exists regarding long-term complications of the offspring. In this study we aimed to further evaluate the potential implications of peripartum fever on the long-term neurological morbidity of the offspring.
Study Design
A population-based cohort analysis including deliveries between the years 1991 to 2014 in a tertiary referral hospital was conducted. Incidence of hospitalizations (up to age 18 years) due to various neurological morbidities was compared between offspring delivered following peripartum fever, and those who were not. A Kaplan-Meier survival curve was used to assess cumulative neurological hospitalization incidence. A Cox proportional hazards model was used to control for confounders.
Results
During the study period, 2048 (0.84%) of a total 242,342 deliveries were accompanied by maternal peripartum fever. Out of the neurological conditions that were evaluated, the rate of cerebral palsy (CP) was significantly higher among offspring who were delivered following maternal peripartum fever (0.3% vs. 0.1%, P=0.02; Table). In addition, cumulative incidence of hospitalization with CP was significantly higher throughout the study period (Kaplan-Meier survival curve log rank p-value< 0.001; Figure). This association between peripartum fever and CP remained significant after controlling for gestational age (adjusted HR = 3.35; 95% CI 1.57-7.11, P=0.002) using a Cox proportional hazards model.
Conclusion
Maternal peripartum fever is independently associated with cerebral palsy. Our findings expand the knowledge about the impact of peripartum fever on future neurological morbidity of the offspring.
Maternal peripartum fever can be caused by a number of infectious and non-infectious etiologies, and has been associated with the development of adverse maternal and neonatal outcome. Newborn consequences of maternal peripartum fever may include short-term complications such as sepsis, meningitis and pneumonia. Insufficient data exists regarding long-term complications of the offspring. In this study we aimed to further evaluate the potential implications of peripartum fever on the long-term neurological morbidity of the offspring.
Study Design
A population-based cohort analysis including deliveries between the years 1991 to 2014 in a tertiary referral hospital was conducted. Incidence of hospitalizations (up to age 18 years) due to various neurological morbidities was compared between offspring delivered following peripartum fever, and those who were not. A Kaplan-Meier survival curve was used to assess cumulative neurological hospitalization incidence. A Cox proportional hazards model was used to control for confounders.
Results
During the study period, 2048 (0.84%) of a total 242,342 deliveries were accompanied by maternal peripartum fever. Out of the neurological conditions that were evaluated, the rate of cerebral palsy (CP) was significantly higher among offspring who were delivered following maternal peripartum fever (0.3% vs. 0.1%, P=0.02; Table). In addition, cumulative incidence of hospitalization with CP was significantly higher throughout the study period (Kaplan-Meier survival curve log rank p-value< 0.001; Figure). This association between peripartum fever and CP remained significant after controlling for gestational age (adjusted HR = 3.35; 95% CI 1.57-7.11, P=0.002) using a Cox proportional hazards model.
Conclusion
Maternal peripartum fever is independently associated with cerebral palsy. Our findings expand the knowledge about the impact of peripartum fever on future neurological morbidity of the offspring.
| Original language | English |
|---|---|
| Pages (from-to) | S252-S253 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 222 |
| Issue number | 1,Supplement |
| DOIs | |
| State | Published - Jan 2020 |