Labor
epidural analgesia (LEA) is allegedly associated with maternal
fever and an increase in the newborn
sepsis work-up (SWU) rate. In this study, we evaluated whether LEA causes an increase in the SWU rate compared with a Control group given parenteral
narcotics for
labor pain. Maternal and neonatal data were collected prospectively for a continuous quality improvement database. Odds ratios were calculated by using multiple logistic regression for various triggers for SWU in the neonate. Of the 1177 primiparous women and their neonates studied, 922 women received LEA and 255 women received parenteral
analgesics. A small but statistically significant increase in maternal and neonatal temperatures occurred in parturients receiving LEA. The SWU rates were 7.5% in the LEA group and 9.4% in the Controls (not significant). Triggers identified for SWU were
birth weight (odds ratio = 116, P = 0.000), gestational age (odds ratio = 86.6, P = 0.000),
meconium aspiration and respiratory distress requiring intubation (odds ratio = 8.6, P = 0.000),
hypothermia at birth (odds ratio = 7.1, P = 0.001), maternal Group B beta-hemolytic streptococcal colonization (odds ratio = 6, P = 0.000), and
preeclampsia or
hypertension (odds ratio = 3.5, P = 0.03). There was no association between LEA and SWU.
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