The effect of intrapartum maternal fever on neonatal outcomes: a systematic review and meta-analysis
Bibliographic record
Abstract
Objective: To systematically review the link between intrapartum maternal fever and adverse neonatal outcomes in term singleton pregnancies not complicated by chorioamnionitis. Methods: The PubMed, Web of Science, Scopus, and Embase databases were searched for studies published up to June 30, 2024, that reported data on women with term singleton pregnancies and intrapartum fever. Studies describing cases of chorioamnionitis (CAM) were excluded. The included studies had to have defined exclusion criteria to ensure that women with a high likelihood of CAM were excluded. Neonatal outcomes of interest were infection/sepsis, fetal distress, assisted ventilation, low APGAR scores, neonatal intensive care unit (NICU) admission, seizures, and hypotonia. Study quality was assessed by the Newcastle-Ottawa Scale (NOS). A random-effects model was used to pool effect sizes, which were reported as odds ratios (OR) and weighted mean differences (WMD). Funnel plots and Egger's test were used to assess publication bias. Results: = 153,410) were included. Neonates born to mothers with intrapartum fever had a higher risk of low APGAR scores (OR 2.97, 95% CI: 1.61, 5.48), need for assisted ventilation (OR 2.50, 95% CI: 1.59, 3.93), infection/sepsis (OR 6.01, 95% CI: 2.68, 13.5), NICU admission (OR 2.77, 95% CI: 1.40, 5.51), seizures (OR 4.25, 95% CI: 1.95, 9.22), and hypotonia (OR 4.19, 95% CI: 1.72, 10.2). The birth weight of neonates delivered by febrile mothers was significantly higher (WMD 63.4 g, 95% CI: 16.2, 110.5). Publication bias was noted for low APGAR scores and neonatal infection/sepsis. Conclusion: Intrapartum maternal fever appears to be associated with increased risks of adverse neonatal outcomes. However, the challenge of entirely excluding CAM-related fever and variability in study methodologies limits the robustness of the findings. Nonetheless, proactive management of maternal fever during labor could be critical. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024565830, PROSPERO CRD42024565830.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.022 | 0.031 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".