Newly Published
Perioperative Medicine  |   September 2017
Association between Intrapartum Magnesium Administration and the Incidence of Maternal Fever: A Retrospective Cross-sectional Study
Author Notes
  • From the Departments of Anesthesiology (E.M.S.L., C.A.W., P.T.) and Obstetrics and Gynecology (W.A.G.) and Center for Healthcare Studies (W.A.G., P.T.), Northwestern University Feinberg School of Medicine, Chicago, Illinois; Departments of Anesthesiology (S.S.) and Biostatistical Sciences (G.B.R.), Wake Forest Baptist Medical Center, Winston-Salem, North Carolina; Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan (C.P.); and Department of Anesthesia, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa (C.A.W.).
  • Submitted for publication January 20, 2017. Accepted for publication August 2, 2017.
    Submitted for publication January 20, 2017. Accepted for publication August 2, 2017.×
  • Research Support: Supported by award No. 69779 from the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program (Princeton, New Jersey; to Dr. Toledo) and with funding from the Department of Anesthesiology, Northwestern University Feinberg School of Medicine (Chicago, Illinois) and the Department of Anesthesiology, Wake Forest Baptist Medical Center (Winston-Salem, North Carolina).
    Research Support: Supported by award No. 69779 from the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program (Princeton, New Jersey; to Dr. Toledo) and with funding from the Department of Anesthesiology, Northwestern University Feinberg School of Medicine (Chicago, Illinois) and the Department of Anesthesiology, Wake Forest Baptist Medical Center (Winston-Salem, North Carolina).×
  • Competing Interests: The authors declare no competing interests.
    Competing Interests: The authors declare no competing interests.×
  • Correspondence: Address correspondence to Dr. Lange: 251 E. Huron Street, F5-704, Chicago, Illinois 60611. elizabeth.lange@northwestern.edu.Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Perioperative Medicine / Obstetric Anesthesia
Perioperative Medicine   |   September 2017
Association between Intrapartum Magnesium Administration and the Incidence of Maternal Fever: A Retrospective Cross-sectional Study
Anesthesiology Newly Published on September 7, 2017. doi:10.1097/ALN.0000000000001872
Anesthesiology Newly Published on September 7, 2017. doi:10.1097/ALN.0000000000001872
Abstract

Background: Intrapartum maternal fever is associated with several adverse neonatal outcomes. Intrapartum fever can be infectious or inflammatory in etiology. Increases in interleukin 6 and other inflammatory markers are associated with maternal fever. Magnesium has been shown to attenuate interleukin 6–mediated fever in animal models. We hypothesized that parturients exposed to intrapartum magnesium would have a lower incidence of fever than nonexposed parturients.

Methods: In this study, electronic medical record data from all deliveries at Northwestern Memorial Hospital (Chicago, Illinois) between 2007 and 2014 were evaluated. The primary outcome was intrapartum fever (temperature at or higher than 38.0°C). Factors associated with the development of maternal fever were evaluated using a multivariable logistic regression model. Propensity score matching was used to reduce potential bias from nonrandom selection of magnesium administration.

Results: Of the 58,541 women who met inclusion criteria, 5,924 (10.1%) developed intrapartum fever. Febrile parturients were more likely to be nulliparous, have used neuraxial analgesia, and have been delivered via cesarean section. The incidence of fever was lower in women exposed to magnesium (6.0%) than those who were not (10.2%). In multivariable logistic regression, women exposed to magnesium were less likely to develop a fever (adjusted odds ratio = 0.42 [95% CI, 0.31 to 0.58]). After propensity matching (N = 959 per group), the odds ratio of developing fever was lower in women who received magnesium therapy (odds ratio = 0.68 [95% CI, 0.48 to 0.98]).

Conclusions: Magnesium may play a protective role against the development of intrapartum fever. Future work should further explore the association between magnesium dosing and the incidence of maternal fever.