中国实用妇科与产科杂志2024，Vol.40Issue(10)：1036-1041,6.DOI:10.19538/j.fk2024100115
产时发热的危险因素分析
Analysis of the risk factors for intrapartum fever
摘要
Abstract
Objective To analyze the risk factors of intrapartum fever and explore the optimal management of intrapartum fever.Methods This was a prospective cohort study,which included pregnant women who delivered in the Peking University Third Hospital from January to December 2021.Inclusion criteria:singleton,cephalic presentation,gestational weeks of delivery≥34 weeks;exclusion criteria:pregnant women who had fever or infectious diseases before delivery,refused vaginal delivery,had scar uterus,had complications and contraindications to vaginal delivery.Significant structural or chromosomal abnormalities exist in the stillbirth or fetus.To analyze the influence of pregnant women's situation,labor process mangment,labor analgesia and other factors on intrapartum fever.Intrapartum fever was defined as the temperature≥38 ℃ from labor to delivery.Results Totally 3870 cases were included.There were 200 cases with intrapartum fever,accounting for 5.17％.There was no significant association with intrapartum fever such as age,perpregancy body mass index(BMI),weigh gain during pregnancy,gestational weeks of delivery,comborbidities such as hyperglycemia disease,thyroid dysfuction,autoimmune siseases,fetal conditions,fetal conditions such as sex,birth weight.Compared with the non-fever group,the fever group got higher proportion of primipara(92.00％vs.78.34％,P＜0.001),hypertensive disorders(20.00％vs.12.89％,P=0.004),group B Streptococcus(GBS)(4.50％vs.1.69％,P=0.004),induced labor(47.00％vs.30.74％,P＜0.001),artificial rupture of membranes before labor(19.00％vs.7.66％,P＜0.001),labor analgesia(48.50％vs.35.97％,P＜0.001),the total labor duration[8.04(4.48,14.38)h vs.5.75(1.37,13.38)h],the time from rupture of membranes to delivery[11.00(7.59,15.00)h vs.8.83(5.50,13.40)h],and the time of antenatal hospitalization[44.16(18.24,76.32)h vs.39.57(38.71,40.29)h].Stratified analysis showed that induced labor,artificial rupture of membranes,and prolonged antenatal hospitalization were also related to the degree of fever.Conclusions It is necessary to carefully consider the indications of labor induction and the benefits,and pay attention to shortening the time of and improving the success rate of labor induction,avoiding artificial rupture of membranes.Provided standardized treatment of GBS during labor was very important.关键词
产时发热/分娩镇痛/GBS阳性/人工干预/住院时间Key words
intrapartum fever/labor analgesia/group B Streptococcus postive/medical intervention/hospitalization time分类
医药卫生引用本文复制引用
王颖,石慧峰,杨怡珂,张龑,魏瑗,赵扬玉..产时发热的危险因素分析[J].中国实用妇科与产科杂志,2024,40(10):1036-1041,6.基金项目
国家重点研发计划(2021YFC2700700) （2021YFC2700700）
