Fever, Labor
Conditions
Keywords
Fever, Labor, Puerpueral infection, Anti-Bacterial Agents
Brief summary
* Fever during labor affects more than 8% of parturients. It is a heterogeneous entity and can be due to an infectious process, a side effect of a drug, or to labor itself (physiological hyperthermia). * It has been the subject of several retrospective studies and a few prospective studies with varying methodologies, definitions, and inclusion criteria. None have proposed a combined obstetric, neonatal, infectious disease, and microbiological analysis. * It raises concerns about the possibility of an emerging maternal (obstetric or otherwise) and/or fetal infection. * Analysis of the available literature does not clarify the exact frequency of these infections or the predictive factors for their occurrence. * It often justifies systemic antibiotic therapy, the modalities and benefits of which have never been evaluated. The investigators aim to conduct a prospective multicenter study to analyze fever during labor with a combined obstetric, infectious disease, pediatric, and microbiological perspective.
Detailed description
The primary objective of this study is to analyze the causes of fever during labor by categorizing them into 3 etiological categories: 1. Fever indicative of maternofetal infection: potentially early intrauterine infection leading to proven or probable early-onset neonatal bacterial infection, endometritis, or maternal sepsis. 2. Fever indicative of maternal infectious pathology outside the obstetrical field (e.g., pyelonephritis, influenza, COVID, etc.). 3. Fever of non-infectious origin. Secondary objectives include: * Describing the epidemiology and local ecology of bacterial infections. * Identifying predictive factors for each category (obstetrical infection, non-obstetrical infection, and non-infectious fever) when fever occurs during labor. * Evaluating the maternal and neonatal prognosis of mother-child pairs who do not receive antibiotic treatment according to local protocols (e.g., in cases of fever below a threshold value). Depending on the results and sample size, the study will also attempt to evaluate the maternal and neonatal prognosis of mother-child pairs in cases where fever is attributed to maternofetal infectious causes (category 1) according to the antibiotic management strategy for fever during labor at each center.
Interventions
OTHERNon applicable
Non applicable
Sponsors
URC-CIC Paris Descartes Necker Cochin
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Pregnant women at least more than 37 weeks * Who have not opposed the collection of their health data for the purposes of studies and analyzes * In work between 07/01/2023 and 06/01/2024 * Admitted to the work room at Port Royal, Necker Sick Children or Trousseau * With fever defined as a tympanic temperature \> 38°C at least 2 times at 10 min intervals during labor.
Exclusion criteria
* Pregnant women : * \< 37NT * express their opposition to the collection of their data for research purposes * minors or under legal protection * context of medical termination of pregnancy or fetal death
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of maternal-fetal infections | Up to 6 months | intrauterine infection possibly responsible for early neonatal bacterial infection (proven or probable), endometritis, maternal sepsis |
| Percentage of proven maternal bacterial infections | Up to 6 months | (non-obstetric, intrauterine, endometritis) |
| Percentage of proven and probable early neonatal infections | Up to 6 months | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Occurrence of serious accident III or IV linked to the prescription of antibiotics | Up to 6 months | Maternal and neonatal prognosis |
| occurrence of proven or probable early neonatal infection | Up to 6 months | Maternal and neonatal prognosis |
| Percentage of antibiotic therapy | Up to 6 months | Type of care by category |
| occurrence of endometritis | Up to 6 months | Maternal and neonatal prognosis |
| Occurrence of maternal sepsis | Up to 6 months | Maternal and neonatal prognosis |
Countries
France
Outcome results
None listed