Intrapartum epidural analgesia and maternal temperature regulation

Obstet Gynecol. 2007 Mar;109(3):687-90. doi: 10.1097/01.AOG.0000255976.14297.f6.


Objective: To examine maternal temperature changes after epidural analgesia.

Methods: A prospective cohort of nulliparas at term was monitored with hourly maternal tympanic temperatures after epidural analgesia (n=99). Temperature response after epidural analgesia was examined in the group as a whole. Subsequently, mean maternal temperature curves were compared between women who remained afebrile throughout labor (n=77) and women who developed intrapartum fever with body temperature greater than 100.4 degrees F (n=22). Baseline maternal characteristics were assessed.

Results: Women who later developed intrapartum fever had a higher mean temperature within 1 hour after epidural analgesia. In contrast, women who remained afebrile had no increase in core temperature. During the first 4 hours after epidural analgesia initiation, women who later develop intrapartum fever have an increase in mean tympanic temperature of 0.33 degrees F per hour.

Conclusion: Epidural analgesia is not associated with increased temperature in the majority of women. Hyperthermia is an abnormal response confined to a minority subset, which occurs immediately after exposure. Our findings do not support a universal perturbation of maternal thermoregulation after epidural analgesia.

Level of evidence: II.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesia, Epidural*
  • Body Temperature Regulation / physiology*
  • Female
  • Humans
  • Labor, Obstetric / physiology*
  • Pregnancy
  • Prospective Studies
  • Puerperal Disorders / physiopathology*
  • Time Factors