Suspected chorioamnionitis with peak intrapartum temperature <380C : The prevalence of confirmed chorioamnionitis  and short term neonatal outcome     

Background: Chorioamnionitis(CA) affects up to 3.9% of all deliveries worldwide, and is one of the leading causes of early onset neonatal sepsis. Fever ≥ 38 0 C is an essential criterion for the clinical diagnosis of CA. Obstetricians frequently take the maternal risk factors into consideration, and many mothers are treated as CA even with peak intrapartum temperature(PIT) between 37.6 0 C to 37.9 0 Cif they have other clinical signs and risk factors. Aim to estimate the prevalence of confirmed chorioamnionitis and adverseneonatal outcomes among those mothers with PIT below38 0 C. Materials and methods Retrospective chart review among mothers delivered at Al-Wakra Hospital, Qatar, between1st January2016 to 31st December 2019 with a clinical diagnosis of CA. Results Among 21,471 mothers, 442 were suspected of having CA(2.06%, 95% CI 1.88 to 2.26%). After exclusions, 415 were included in the study, 203(48.9%) mothers had PIT between 37.6-37.9 0 C. There was no significant difference in the rate of confirmed CA between the low(< 38 0 C) andhigher(≥ 38 0 C ) temperature groups(25.4%Vs.31.3%,OR0.75, 95%CI0.46-1.25,p.262). More patients in the low-temperature group received paracetamol for PIT between 37.6 to 37.9 0 C, while it was less frequently used for such milder elevation in higher temperature group(88.2%Vs.38.9%, OR11.69, 95% CI 6.46–2.15, p < .001) Conclusion The incidence of CA in our institution waswithin the international rates. Although nearly half of the mothers with suspected CA had peak temperature below the recommended diagnostic criteria, the rate of confirmed CA and neonatal outcome was not significantly different from those with PIT ≥ 38 0 C. Early antipyretic use might have affected further elevation of temperature.