Epidurals Potentially Cause Fevers During Labor

by Cassandra R. Elias

You thought it was just your hormones or the hard work, and that's why rivulets of sweat are pouring off your body -- but it's not.

If you had an epidural, you're more likely to run a fever during labor. A study recently published in "Pediatrics" found that as having an epidural increased your risk of a fever and that as your temperature rose, the baby was more likely to experience problems.

"Fever of more than 100.4°F developed during labor in 19% of epidural users compared with just 2% of those who went without," said Elizabeth Greenwell, a doctoral candidate at Harvard School of Public Health when she did the research.

The study looked at more than 2000 low-risk, first-time moms in labor at Brigham and Women's Hospital.

In the group of women receiving epidurals,

• 8.6 percent developed a fever of higher than 101 degrees
• 10.7 percent had a temperature of 100.5 to 101 degrees
• 25.5 percent had a temperature of 99.6 degrees to 100.4 degrees

Babies whose mothers develop an epidural fever face a greater risk of having problems right after birth -- the higher the temperature, the greater risk. If mom's temperate is over 101%deg; the baby is:

• Two to six more likely to have poor muscle tone
• Almost three times more likely to require rescusitation or need ventilation
• Twice as likely to have a one-minute Apgar scores under 7
• Four times as likely to have a five-minute Apgar score under 7
• 6.5 times more apt to experience early-onset seizures

"It's clear that from our data that about 20 percent of the term infants born to mothers who received epidurals experienced one or more adverse outcomes after birth," Greenwell said.

What Can You Do?

Does this mean you shouldn't have an epidural?

That's a decision only you and your caregiver can make.

We encourage you to weigh the risks and benefits, study other childbirth options, and if you decide an epidural meets your needs, consider these tips that could help keep your temperature normal.

• Hydration helps keep temperature normal during labor. You're working hard. You need plenty of fluid. Drink water if allowed. Otherwise, your caregiver may might to insert a drip to administer extra fluids.
• Keep your room cool. Too warm a room or too hot a tub or shower can increase your body temperature. Keep the room cool and comfortable for you.
• Postpone your epidural as long as possible.Previous studies have suggested that the incidence of epidural fever rises significantly once an epidural has been in place four hours. If this is your first baby, try to wait until you're eight centimeters. For second time (and more) moms, unless your labor is progressing very slowly, consider getting your epidural at six centimeter.

Are you planning an epidural this birth? Will your timing or birth plan change with the release of this study? Please share your thought in the comments.

About the study: Elizabeth Greenwell, Sc.D., University of Colorado Denver, Colorado School of Public Health; Eva Pressman, M.D., maternal-fetal medicine specialist, University of Rochester Medical Center, Rochester, N.Y.; February 2012 Pediatrics.

The study consisted of all low-risk pregnancy for first-time women carrying a single baby to term pregnancies from Brigham and Women's Hospital during 2000. Colleagues looked for an association of fever during labor with adverse neonatal outcomes.

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