{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:20:25Z","timestamp":1789802425077,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Epidural labor analgesia is associated with intrapartum maternal fever, termed epidural\u2010related maternal fever (ERMF). Reliable risk stratification tools to support intrapartum monitoring and management are limited. We aimed to develop and internally validate a multivariable prediction model for ERMF among parturients receiving programmed intermittent epidural bolus (PIEB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010center retrospective cohort study of term (37\u201341\u2009weeks), singleton, cephalic pregnancies with vaginal delivery who received PIEB between January and December 2024. ERMF was defined as axillary temperature \u226538.0\u00b0C confirmed by two measurements 30\u2009min apart after PIEB initiation. Candidate predictors were prespecified based on clinical plausibility. Univariable and multivariable logistic regression were performed with multicollinearity assessed by variance inflation factor. Model discrimination was evaluated by area under the receiver operating characteristic curve (AUC) and precision\u2013recall AUC (PR\u2010AUC). Internal validation used 1000 bootstrap resamples. Calibration was assessed by bootstrap\u2010corrected calibration curves and Brier score. Clinical utility was examined using decision curve analysis (DCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2800 women, 308 (11.0%) developed ERMF. Independent predictors included longer first\u2010stage labor duration, primiparity, artificial rupture of membranes, amniotic fluid contamination \u2265grade 2, and higher cumulative oxytocin dose. The model achieved an AUC of 0.75, PR\u2010AUC of 0.254, and Brier score of 0.090; bootstrap validation showed stable performance. DCA suggested net benefit over treat\u2010all\/treat\u2010none strategies across a wide range of threshold probabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A multivariable logistic regression model using routinely available intrapartum variables demonstrated stable discrimination, calibration, and potential clinical utility for ERMF risk assessment and bedside implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70963","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:02:42Z","timestamp":1774519362000},"page":"1526-1535","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a multivariable logistic regression model for predicting epidural\u2010related maternal fever during labor analgesia: A retrospective cohort study"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9288-9483","authenticated-orcid":false,"given":"Junyang","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Maternal and Child Health Hospital of Hubei Province  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Maternal and Child Health Hospital of Hubei Province  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiqi","family":"Sun","sequence":"additional","affiliation":[{"name":"Huazhong University of Science and Technology Tongji Medical College Union Hospital  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Maternal and Child Health Hospital of Hubei Province  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"issue":"5","key":"e_1_2_11_2_1","first-page":"Cd000331","article-title":"Epidural versus non\u2010epidural or no analgesia for pain management in labour","volume":"5","author":"Anim\u2010Somuah M","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(89)92341-6"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.06.026"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005905"},{"issue":"11","key":"e_1_2_11_6_1","first-page":"2110","article-title":"Does the presence of epidural analgesia reduce the risk of neonatal sepsis in the setting of an intrapartum fever?","volume":"35","author":"Ward C","year":"2022","journal-title":"s"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.545923"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-2301"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200207000-00022"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00254-O"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.09.024"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.09.039"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004402"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-200202000-00034"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181f713d4"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01071.2005"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.99.3.415"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-994103"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)30513-8"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12477"},{"issue":"6","key":"e_1_2_11_21_1","first-page":"617","article-title":"Association between epidural analgesia during labor and fever","volume":"36","author":"Vinson DC","year":"1993","journal-title":"J Fam Pract"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2015.06.003"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199905000-00008"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200203000-00007"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7210967"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2007.07.006"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1668597"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000042939"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2025.1614770"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.11.002"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-289X(97)80047-7"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005593"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.06.041"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2014.11.008"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002236"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2000-9283"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.108.5.1099"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7211128"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.06.022"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7594"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70963","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.70963","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70963","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:33:03Z","timestamp":1789799583000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.70963"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":39,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ijgo.70963"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.70963","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]},"assertion":[{"value":"2025-12-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}