{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T19:56:39Z","timestamp":1785182199962,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,2,15]],"date-time":"2015-02-15T00:00:00Z","timestamp":1423958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2015,4]]},"abstract":"Background<\/jats:title>Maternal intrapartum fever (MF<\/jats:styled-content>) is associated with neonatal sequelae, and women in labour who receive epidural analgesia (EA<\/jats:styled-content>) are more likely to develop hyperthermia. The aims of this study were to investigate if EA<\/jats:styled-content> and\/or a diagnosis of MF<\/jats:styled-content> were associated to adverse neonatal outcomes at a population level.<\/jats:p><\/jats:sec>Methods<\/jats:title>Population\u2010based register study with data from the S<\/jats:styled-content>wedish B<\/jats:styled-content>irth R<\/jats:styled-content>egister and the S<\/jats:styled-content>wedish N<\/jats:styled-content>ational P<\/jats:styled-content>atient R<\/jats:styled-content>egister, including all nulliparae (n<\/jats:italic>\u2009=\u2009294,329) with singleton pregnancies who gave birth at term in S<\/jats:styled-content>weden 1999\u20132008. Neonatal outcomes analysed were A<\/jats:styled-content>pgar score (AS<\/jats:styled-content>)\u2009<\u20097 at 5\u2009min and ICD<\/jats:styled-content>\u201010 diagnosis of neonatal encephalopathy (e.g. convulsions or neonatal cerebral ischaemia). Multivariate logistic regression was used to calculate adjusted odds ratios (AOR<\/jats:styled-content>) with 95% confidence intervals (CI<\/jats:styled-content>).<\/jats:p><\/jats:sec>Results<\/jats:title>EA<\/jats:styled-content> was used in 44% of the deliveries. Low AS<\/jats:styled-content> or encephalopathy was found in 1.26% and 0.39% of the children in the EA<\/jats:styled-content> group compared with 0.80% and 0.29% in the control group. In multivariate analysis, EA<\/jats:styled-content> was associated with increased risk with low AS<\/jats:styled-content>, AOR<\/jats:styled-content> 1.27 (95% CI<\/jats:styled-content> 1.16\u20131.39), but not with diagnosis of encephalopathy, 1.11 (0.96\u20131.29). A diagnosis of MF<\/jats:styled-content> was associated with increased risk for both low AS<\/jats:styled-content>, 2.27 (1.71\u20133.02), and of neonatal encephalopathy, 1.97 (1.19\u20133.26).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Diagnosis of MF<\/jats:styled-content> was associated with low AS<\/jats:styled-content> and neonatal encephalopathy, whereas EA<\/jats:styled-content> was only associated with low AS<\/jats:styled-content> and not with neonatal encephalopathy. The found associations might be a result of confounding by indication, which is difficult to assess in a registry\u2010based population study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.12477","type":"journal-article","created":{"date-parts":[[2015,2,16]],"date-time":"2015-02-16T01:58:51Z","timestamp":1424051931000},"page":"486-495","source":"Crossref","is-referenced-by-count":50,"title":["Low A<\/scp>pgar score, neonatal encephalopathy and epidural analgesia during labour: a S<\/scp>wedish registry\u2010based study"],"prefix":"10.1111","volume":"59","author":[{"given":"S.","family":"T\u00d6RNELL","sequence":"first","affiliation":[{"name":"Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"EK\u00c9US","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Division of Reproductive Health Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"HULTIN","sequence":"additional","affiliation":[{"name":"Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"H\u00c5KANSSON","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Paediatrics Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"THUNBERG","sequence":"additional","affiliation":[{"name":"Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"H\u00d6GBERG","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.1.8"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00145.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03550030047032"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7172.1554"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(01)01361-8"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31825a30ef"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00254-O"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.127135"},{"key":"e_1_2_7_10_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_7_11_1","first-page":"665","article-title":"Epidural analgesia in labor and fetal hyperthermia","volume":"80","author":"Macaulay JH","year":"1992","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03020380"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/67.5.565"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(89)92341-6"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199203000-00029"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.545923"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(98)00415-3"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181f713d4"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000255976.14297.f6"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199508000-00013"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.21.9.1318"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199311000-00017"},{"issue":"12","key":"e_1_2_7_23_1","article-title":"Epidural versus non\u2010epidural or no analgesia in labour","author":"Anim\u2010Somuah M","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-450"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2003.00112.x"},{"key":"e_1_2_7_26_1","first-page":"179","article-title":"Computer analysis of labor progression. 3. 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