{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:55:40Z","timestamp":1782924940804,"version":"3.54.5"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association between intrapartum fever, clinical chorioamnionitis, and the risk of obstetric anal sphincter injuries (OASIS) in term vaginal deliveries, stratified by fever severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included all singleton, term (\u226537\u2009weeks), vertex vaginal deliveries at Galilee Medical Center between March 2020 and March 2025. The primary exposures were intrapartum fever\u2014categorized as none, 38.0\u201338.9\u00b0C, and \u2265\u200939.0\u00b0C\u2014and clinical chorioamnionitis, defined as maternal fever with at least one of the following: leukocytosis (&gt;15\u2009000\/mm\n                      <jats:sup>3<\/jats:sup>\n                      ), fetal tachycardia (&gt;160\u2009bpm), or foul\u2010smelling amniotic fluid. The primary outcome was OASIS (third\u2010 or fourth\u2010degree perineal tears) diagnosed postpartum by obstetricians. Multivariable logistic regression was used to adjust for potential confounders, including nulliparity, body mass index (BMI), birth weight, gestational age, delivery mode, mediolateral episiotomy, and second\u2010stage duration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 15\u2009571 term vaginal deliveries, OASIS occurred in 93 (0.6%). The incidence increased with fever severity\u201483\/15114 (0.6%) in afebrile women, 9\/424 (2.1%) with moderate fever, and 1\/21 (4.8%) with \u226539.0\u00b0C (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u20090.001). Clinical chorioamnionitis was also associated with OASIS (3.45% vs. 0.58%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u20090.001). Independent risk factors for OASIS included nulliparity (adjusted odds ratio [aOR] 3.64, 95% confidence interval [CI]: 2.08\u20136.38), BMI &lt;18.5 (aOR 24.90, 95% CI: 2.98\u2013208.24), birth weight&gt;4000\u2009g (aOR 2.69, 95% CI: 1.40\u20135.18), intrapartum fever (aOR 2.57, 95% CI: 1.29\u20135.12), clinical chorioamnionitis (aOR 3.65, 95% CI: 1.27\u201310.47), and gestational age \u2265\u200941\u2009weeks (aOR 1.91, 95% CI: 1.12\u20133.25).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intrapartum fever and clinical chorioamnionitis independently increase OASIS risk in term vaginal births, showing a clear dose\u2013response relationship with fever severity.<\/jats:p>\n                  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