Fever in childbirth: a mini-review of epidural-related maternal fever

Yuki Kinishi; Yoshihisa Koyama; Tomoo Yuba; Yuji Fujino; Shoichi Shimada

doi:10.3389/fnins.2024.1389132

Fever in childbirth: a mini-review of epidural-related maternal fever

Front Neurosci. 2024 Apr 19:18:1389132. doi: 10.3389/fnins.2024.1389132. eCollection 2024.

Authors

Yuki Kinishi^{1

2}, Yoshihisa Koyama^#^{2

3

4

5}, Tomoo Yuba^{1

2}, Yuji Fujino¹, Shoichi Shimada^{2

3

4}

Affiliations

¹ Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
² Department of Neuroscience and Cell Biology, Osaka University Graduate School of Medicine, Osaka, Japan.
³ Addiction Research Unit, Osaka Psychiatric Research Center, Osaka Psychiatric Medical Center, Osaka, Japan.
⁴ Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan.
⁵ Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Suita, Japan.

^# Contributed equally.

Abstract

Fever during childbirth, which is often observed in clinical settings, is characterized by a temperature of 38°C or higher, and can occur due to infectious and non-infectious causes. A significant proportion of non-infectious causes are associated with epidural-related maternal fever during vaginal delivery. Therapeutic interventions are required because fever has adverse effects on both mother and newborn. Effective treatment options for ERMF are lacking. As it is difficult to distinguish it from intrauterine infections such as chorioamnionitis, antibiotic administration remains the only viable option. We mentioned the importance of interleukin-1 receptor antagonist in the sterile inflammatory fever pathway and the hormonal influence on temperature regulation during childbirth, an important factor in elucidating the pathophysiology of ERMF. This review spotlighted the etiology and management of ERMF, underscoring recent advancements in our understanding of hypothalamic involvement in thermoregulation and its link to sterile inflammation. We propose to deepen the understanding of ERMF within the broader context of autonomic neuroscience, aiming to foster the development of targeted therapies.

Keywords: epidural anesthesia; epidural-related maternal fever; interleukin-1 receptor antagonist; intrapartum fever; sterile inflammation.

Publication types

Review

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This research was supported by Osaka University Hospital, Osaka, Japan.