Epidurals for labor pain

  • Because fever is a symptom of infection, babies of mothers who run fevers will likely be subjected to a septic work-up, (multiple blood tests and a spinal tap) kept in the nursery for observation and possibly given preventative I.V. antibiotics until cultures come back negative. In this same study, newborns whose mothers had epidurals were over three times more likely (34 percent versus 10 percent) to have septic workups and four times more likely (15 percent versus 4 percent) to have antibiotic treatment.

    Some studies suggest epidurals are associated not just with fever, but with actual newborn infection. In a study of over 3,000 women, less than one woman in five had an epidural, but nearly three-quarters of the 18 infants with potentially serious infections had mothers who had epidurals (13). Another study found that epidurals were associated with fever in labor but only when there was also placental inflammation, an indicator of infection (10). Epidurals could increase the risk of newborn infection by prolonging labor. Prolonged labor with ruptured membranes increases the risk of infection because women are more likely to have multiple vaginal exams, internal electronic fetal monitoring,and possibly a cesarean section..

    Epidural fevers are also associated with newborn problems not related to infection (17). A study found that among newborns whose mothers ran fevers over 101 degrees F during labor, 11.5 percent versus 3 percent required resuscitation, 8 percent versus 1 percent needed oxygen therapy in the nursery, and 5 percent versus 0.5 percent were limp and weak at birth (hypotonia). Ninety-eight percent of women who ran temperatures over 100.4 degrees F had epidurals. Newborns were also much more likely to have a seizure (2 out of 61 versus 2 out of 1095), but those numbers were too small to draw a conclusion.

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