Do epidurals cause higher intrapartum temperatures in parturients and neonates? A Belgian experience

In a prospective study including 200 parturients, maternal and neonatal temperatures were registered and changes were evaluated in relationship with epidural treatment, duration of labor or parity. Epidural analgesia was more often requested by nulliparous parturients, prolonged the duration of labor by approximately 1 hour and also resulted in more need for oxytocin. Parturients receiving epidural analgesia had a higher body temperature at full cervical dilation as compared to their non-epidural counterparts. In the epidural group 31.1% of women had temperatures > 37.5°C versus only 8.9% in the non-epidural group (p < 0.001). However, epidurally-induced fever was not significantly correlated with parity (p = 0.3) and duration of labor (p = 0.8) although. Similarly, neonates of epidurally treated mothers also had higher body temperatures. This fever does not cause a problem in a vast majority of mothers and neonates with respect to early outcome parameters. More studies are needed to develop a reasonable concept of mechanism for this phenomenon, whether it should be considered to be fever or hyperthermia and how it might be prevented. However, there is no reason to dissuade neuraxial analgesia based in the present results while pain-free mothers may cooperate better and may be more satisfied. Alternative analgesic methods such as opioid