{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:15:31Z","timestamp":1785143731108,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":207,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100008402","name":"Chengdu University of Traditional Chinese Medicine","doi-asserted-by":"publisher","award":["XJ2023005701"],"award-info":[{"award-number":["XJ2023005701"]}],"id":[{"id":"10.13039\/501100008402","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obstetrics and Gynecology International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the association between epidural\u2010related maternal fever (ERMF) and maternal vaginal microbiota, as well as its potential association with early infant neurodevelopment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study enrolled pregnant women who underwent vaginal delivery with epidural analgesia. According to the presence or absence of intrapartum fever (body temperature\u2009\u2265\u200937.5 \u00b0C), the participants were divided into either the control group or the fever group. Multiple vaginal swabs were collected from the parturients for further analysis using 16S rRNA amplicon sequencing. The general conditions of both mothers and neonates were recorded. At three months postpartum, infants\u2019 neurodevelopmental status was assessed using the Ages and Stages Questionnaires, Third Edition (ASQ\u20103).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analysis of the vaginal flora demonstrated that Lactobacillus was the dominant genus in both groups. ERMF was not associated with significant changes in the overall alpha diversity of the vaginal microbiota (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.32). However, differences were noted in beta diversity (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03). ERMF was associated with an increased relative abundance of Achromobacter and Porphyromonas, and a decreased relative abundance of\n                      <jats:italic>Ezakiella<\/jats:italic>\n                      in the vaginal microbiota. In functional prediction analysis, ERMF was associated with decreased expression of protein\u2010coding genes related to vaginal microbiota stability. Additionally, infants exposed to ERMF exhibited a downward trend in 3\u2010month ASQ\u20103 neurodevelopmental scores, with no statistically significant difference observed (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.098). Multivariate logistic regression analysis revealed a statistically significant association between ASQ\u20103 scores and duration of labor (OR\u2009=\u20091.189; 95% CI: 1.025 to 1.406;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ERMF is associated with alterations in the structural composition of vaginal microbiota and dysregulation of specific bacterial genera. Labor duration is significantly associated with early infant ASQ\u20103 scores. However, this exploratory study has several limitations\u2014including a relatively small sample size and a short follow\u2010up duration\u2014which preclude definitive conclusions regarding a causal or direct association between ERMF exposure and early infant neurodevelopment. Additional rigorously designed longitudinal studies are warranted to further elucidate and validate this relationship.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Chinese Clinical Trial Registry: ChiCTR2400090531\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/ogi\/7458179","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T08:57:16Z","timestamp":1785142636000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidural\u2010Related Maternal Fever Is Associated With Structural Alterations in Vaginal Floral Homeostasis Among Parturients"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3411-9552","authenticated-orcid":false,"given":"Chao","family":"Xiong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8663-3428","authenticated-orcid":false,"given":"Xuemeng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1267-9003","authenticated-orcid":false,"given":"Wenhu","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2058-1813","authenticated-orcid":false,"given":"Xianjie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_15_1_2","article-title":"Epidural Versus Non-Epidural or No Analgesia for Pain Management in Labour","volume":"5","author":"Anim-Somuah M.","year":"2018","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e3181f713d4"},{"key":"e_1_2_15_3_2","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1213\/ANE.0000000000004576","article-title":"Epidural-Related Maternal Fever: Still a Hot Topic, But What Are the Burning Issues","volume":"130","author":"Sultan P.","year":"2020","journal-title":"Anesthesia & Analgesia"},{"key":"e_1_2_15_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002018"},{"key":"e_1_2_15_5_2","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1542\/peds.99.3.415","article-title":"Epidural Analgesia, Intrapartum Fever, and Neonatal Sepsis Evaluation","volume":"99","author":"Lieberman E.","year":"1997","journal-title":"Pediatrics"},{"key":"e_1_2_15_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.11.002"},{"key":"e_1_2_15_7_2","doi-asserted-by":"crossref","first-page":"e447","DOI":"10.1542\/peds.2010-2301","article-title":"Intrapartum Temperature Elevation, Epidural Use, and Adverse Outcome in Term Infants","volume":"129","author":"Greenwell E. 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