Publication:

Impact of fever in pregnancy on maternal and fetal outcomes: a prospective observational study of 171 cases

Background Fever during pregnancy is a high-risk condition associated with adverse fetomaternal outcomes; however, region-specific data from Indian tertiary care government hospitals remain limited. This study evaluated fetomaternal outcomes and etiological spectrum of fever in pregnancy.

Methods This prospective observational study was conducted over 18 months in the Department of Obstetrics and Gynaecology of a tertiary care government hospital. Total 171 pregnant women with oral/axillary temperature ≥38°C were enrolled after informed consent. Demographic, obstetric, fever-related variables were recorded, maternal and neonatal outcomes were followed until 6weeks postpartum. Data were analysed using SPSS with chi-square/Fisher exact test; p<0.05 was considered statistically significant.

Results Most women were aged 21-35 years (91.2%) and multigravida (52.0%). Fever occurred predominantly in second trimester (43.3%) and was low-to-moderate grade (94.7%). Urinary tract infection (23.4%), typhoid fever (14.6%), upper respiratory tract infection (13.4%) were commonest causes. Vaginal delivery occurred in 49.1%, caesarean section in 43.9%, abortion in 7.0%. Maternal complications occurred in 51.5%, mainly anaemia (19.9%), preterm labour (15.2%); one maternal death. Among neonates, 23.97% required NICU admission, 21% had coexisting adverse outcomes, two intrauterine and two neonatal deaths occurred. Typhoid, dengue, malaria, acute febrile illness of unknown cause, primigravidity, first-trimester fever onset, moderate-grade fever was significantly associated with adverse fetomaternal outcomes(p<0.05).

Conclusions Fever in pregnancy is associated with substantial maternal and neonatal morbidity. Early diagnosis, prompt treatment, close antenatal surveillance may improve fetomaternal outcomes.