Imperial College London
Portrait Picture

DrChristopherMullington

Faculty of Medicine, Department of Surgery & Cancer

Honorary Clinical Senior Lecturer
 
 
 
//

Contact

 

c.mullington

 
 
//

Location

 

Sir Michael Uren HubWhite City Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Morton:2021:10.1016/j.bja.2020.09.046,
author = {Morton, S and Kua, J and Mullington, CJ},
doi = {10.1016/j.bja.2020.09.046},
journal = {British Journal of Anaesthesia},
pages = {500--515},
title = {Epidural analgesia, intrapartum hyperthermia, and neonatal brain injury: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1016/j.bja.2020.09.046},
volume = {126},
year = {2021}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundEpidural analgesia is associated with intrapartum hyperthermia, and chorioamnionitis is associated with neonatal brain injury. However, it is not known if epidural hyperthermia is associated with neonatal brain injury. This systematic review and meta-analysis investigated three questions: (1) does epidural analgesia cause intrapartum hyperthermia, (2) is intrapartum hyperthermia associated with neonatal brain injury, and (3) is epidural-induced hyperthermia associated with neonatal brain injury?MethodsPubMed, ISI Web of Knowledge, The Cochrane Library, and Embase were searched from inception to January 2020 using Medical Subject Headings (MeSH) terms relating to epidural analgesia, hyperthermia, labour, and neonatal brain injury. Studies were reviewed independently for inclusion and quality by two authors (Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach). Two meta-analyses were performed using the Mantel–Haenszel fixed effect method to generate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsForty-one studies were included for Question 1 (646 296 participants), 36 for Question 2 (11 866 021 participants), and two studies for Question 3 (297 113 participants). When the mode of analgesia was randomised, epidural analgesia was associated with intrapartum hyperthermia (OR: 4.21; 95% CI: 3.48–5.09). There was an association between intrapartum hyperthermia and neonatal brain injury (OR: 2.79; 95% CI: 2.54–2.3.06). It was not possible to quantify the association between epidural-induced hyperthermia and neonatal brain injury.ConclusionsEpidural analgesia is a cause of intrapartum hyperthermia, and intrapartum hyperthermia of any cause is associated with neonatal brain injury. Further work is required to establish if epidural-induced hyperthermia is a cause of neonatal brain injury.
AU  - Morton,S
AU  - Kua,J
AU  - Mullington,CJ
DO  - 10.1016/j.bja.2020.09.046
EP  - 515
PY  - 2021///
SN  - 0007-0912
SP  - 500
TI  - Epidural analgesia, intrapartum hyperthermia, and neonatal brain injury: a systematic review and meta-analysis
T2  - British Journal of Anaesthesia
UR  - http://dx.doi.org/10.1016/j.bja.2020.09.046
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000609397000035&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://www.bjanaesthesia.org/article/S0007-0912(20)30854-0/fulltext
VL  - 126
ER  -
Download