{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:01:04Z","timestamp":1790834464600,"version":"4.1.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Questionnaire-reported maternal temperature elevation during neuraxial labor analgesia may vary depending on the outcome definition. We compared nested definitions and examined exploratory associations while addressing incomplete outcome linkage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective registry-based cohort comprised 3,409 labor-analgesia records from July 2022 through March 2023, with 1,658 (48.6%) having a linked questionnaire temperature outcome. The outcomes reported were a fever at or above 38.0\u2005\u00b0C and any elevation in temperature. We used Firth penalized logistic regression for the sparse strict-fever endpoint, conventional logistic regression for the broader endpoint, multiple imputation with 50 imputed datasets for missing covariates, and inverse probability of outcome observation weighting (IPOW) for linkage sensitivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Strict fever was reported in 88\/1,658 linked records [5.3%; 95% confidence interval (CI), 4.3%\u20136.5%], and any elevation was noted in 287\/1,658 (17.3%; 95% CI, 15.6%\u201319.2%). IPOW-standardized estimates were 5.4% and 17.5%, respectively. Among 1,139 complete records, nulliparity had a large but imprecise association with strict fever [Firth-adjusted odds ratio (OR), 8.05; 95% CI, 2.51\u201340.76], whereas the dural puncture epidural estimate crossed the null (OR, 0.60; 95% CI, 0.35\u20131.02). For any elevation, age (OR per year, 1.08; 95% CI, 1.03\u20131.13), nulliparity (OR, 3.23; 95% CI, 1.86\u20135.63), and analgesia duration (OR per 2\u2005h, 1.13; 95% CI, 1.06\u20131.20) were associated with higher odds; duration non-linearity remained exploratory (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Observed questionnaire-reported temperature frequency was definition-dependent. Incomplete outcome linkage, sparse strict-fever events, uncertain temperature timing, and differential laboratory testing limit inference; the findings are exploratory and require prospective validation with continuous timestamped temperature measurement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1960868","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:41:36Z","timestamp":1790833296000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Definition dependence of questionnaire-reported maternal temperature elevation in a retrospective registry cohort of women receiving neuraxial labor analgesia"],"prefix":"10.3389","volume":"13","author":[{"given":"Sumei","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology, Fujian 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