Predoctoral Fellowship for Students with Disabilities

Harvard University (Sch Of Public Hlth), Boston MA

Investigators

Linked publications & trials

Abstract

Early-onset neonatal seizures are strongly associated with the development of adverse neurologic impairment or disability in the child. Recent evidence suggests that maternal fever during labor is an independent risk factor for unexplained neonatal seizures, and neonatal encephalopathy in term infants. Most studies to date have assumed that intrapartum maternal fever is an indicator or marker of infection. However, a strong body of evidence suggests that over 90% of fever during labor in low risk women at term results from the use of epidural analgesia and is unlikely to be infectious in origin. The focus on children born at term and of normal birthweight is significant since few studies seek to identify risk factors in this population. Given the dramatic increase in the use of epidural analgesia for management of labor pain in the past decade, the overall objective of this research is to examine the impact of intrauterine exposure to noninfectious maternal fever during labor on both short and long-term neurologic outcome in the child. The specific aims of the study are: (1) to determine whether the combination of exposure to intrapartum maternal fever and unexplained neonatal seizures is associated with an increased risk of cerebral palsy, seizure disorder or other neurologic morbidity in the child, (2) to assess the effect of maternal fever on delay in attainment of motor milestones during childhood, and (3) to examine the association of maternal fever on adverse neonatal neurologic outcome among women that used epidural analgesia for management of labor pain. The proposed retrospective cohort study will examine these associations by using multivariate regression methods and longitudinal data analysis.