Labour epidural analgesia and anti-infectious management of the neonate: a meta-analysis
-
Michael Heesen
,
Sven Klöhr
Abstract
Background: A known side effect of labour epidural analgesia (EDA) is maternal fever. It is unclear whether this has effects on the anti-infectious management of the neonate.
Methods: A systematic literature search and a hand search of abstract publications were conducted. Studies reporting sepsis evaluation or antibiotic treatment were further assessed. For meta-analysis, risk ratio (RR) and 95% confidence interval (CI) were calculated using the random effects model.
Results: Five relevant articles reporting on 4667 parturients were identified; three were observational studies and two were randomised controlled trials (RCT). The RR for sepsis workup of all studies analysed together was 2.58 (95% CI, 1.06–6.27, P=0.04). The RR for antibiotic treatment of the neonate was 2.76 (95% CI, 1.20–6.31, P=0.02). When considering the RCTs alone, the RRs for sepsis evaluation and antimicrobial treatment were still significantly elevated.
Discussion: Our data suggest that EDA-related maternal hyperthermia results in an increased likelihood of sepsis workup and antibiotic treatment of the infant. A crucial question is whether EDA-related maternal hyperthermia is truly infectious. If not, administration of antibiotics would not be justified and may be dangerous.
©2012 by Walter de Gruyter Berlin Boston
Articles in the same Issue
- Masthead
- Masthead
- Original Articles – Obstetrics
- Vaginal progesterone to prevent preterm birth in multiple pregnancy: a randomized controlled trial
- Association of high-sensitivity C-reactive protein serum levels in early pregnancy with the severity of preeclampsia and fetal birth weight
- High-fidelity simulation increases obstetric self-assurance and skills in undergraduate medical students
- Resident consultant presence in labour ward after midnight – a retrospective cohort study of 5318 deliveries
- Carboxyhemoglobin levels in umbilical cord blood of women with pre-eclampsia and intrauterine growth restriction
- Labour epidural analgesia and anti-infectious management of the neonate: a meta-analysis
- What about ST waveform analysis signal quality in the second stage of labor? A case-control study
- A curriculum to teach and evaluate resident skills in the management of postpartum hemorrhage
- Placental transfer of clarithromycin in human pregnancies with preterm premature rupture of membranes
- Stepwise sequential screening for Down’s syndrome (combined test associated with modified genetic sonography) in pregnant women with low risk for chromosomal disorders
- Original Articles – Fetus
- Mode of anaesthesia on fetal acid-base status at caesarean section
- Development of integrative autonomic nervous system function: an investigation based on time correlation in fetal heart rate patterns
- Original Articles – Newborn
- Guttus, tiralatte and téterelle: a history of breast pumps
- Does docosahexaenoic acid (DHA) status in pregnancy have any impact on postnatal growth? Six-year follow-up of a prospective randomized double-blind monocenter study on low-dose DHA supplements
- The evolution of risk factors for respiratory syncytial virus-related hospitalisation in infants born at 32–35 weeks’ gestational age: time-based analysis using data from the FLIP-2 study
- Short Communications
- Low placental weight and risk for fetal distress at birth
- Electrical pacemaker as a safe and feasible method for decreasing the uterine contractions of human preterm labor
- Congress Calendar
- Congress Calendar
- WAPM Newsletter
- WAPM Newsletter
Articles in the same Issue
- Masthead
- Masthead
- Original Articles – Obstetrics
- Vaginal progesterone to prevent preterm birth in multiple pregnancy: a randomized controlled trial
- Association of high-sensitivity C-reactive protein serum levels in early pregnancy with the severity of preeclampsia and fetal birth weight
- High-fidelity simulation increases obstetric self-assurance and skills in undergraduate medical students
- Resident consultant presence in labour ward after midnight – a retrospective cohort study of 5318 deliveries
- Carboxyhemoglobin levels in umbilical cord blood of women with pre-eclampsia and intrauterine growth restriction
- Labour epidural analgesia and anti-infectious management of the neonate: a meta-analysis
- What about ST waveform analysis signal quality in the second stage of labor? A case-control study
- A curriculum to teach and evaluate resident skills in the management of postpartum hemorrhage
- Placental transfer of clarithromycin in human pregnancies with preterm premature rupture of membranes
- Stepwise sequential screening for Down’s syndrome (combined test associated with modified genetic sonography) in pregnant women with low risk for chromosomal disorders
- Original Articles – Fetus
- Mode of anaesthesia on fetal acid-base status at caesarean section
- Development of integrative autonomic nervous system function: an investigation based on time correlation in fetal heart rate patterns
- Original Articles – Newborn
- Guttus, tiralatte and téterelle: a history of breast pumps
- Does docosahexaenoic acid (DHA) status in pregnancy have any impact on postnatal growth? Six-year follow-up of a prospective randomized double-blind monocenter study on low-dose DHA supplements
- The evolution of risk factors for respiratory syncytial virus-related hospitalisation in infants born at 32–35 weeks’ gestational age: time-based analysis using data from the FLIP-2 study
- Short Communications
- Low placental weight and risk for fetal distress at birth
- Electrical pacemaker as a safe and feasible method for decreasing the uterine contractions of human preterm labor
- Congress Calendar
- Congress Calendar
- WAPM Newsletter
- WAPM Newsletter
