Maternal fever, epidural analgesia, and genetics: implications for the neonate.

Epidural-related maternal fever affects 15-25% of labouring women, but its mechanisms remain uncertain. In a prospective observational study, the EPIFEVER-2 investigators found no firm link between interleukin-1Ra concentrations and epidural-related maternal fever, suggesting other aetiological factors. Clinically, the main challenge lies in distinguishing epidural-related maternal fever from infectious fever to avoid unnecessary antibiotic use and neonatal interventions. Despite the increased risk of fever in women receiving epidural analgesia, there is no strong evidence of harm to the newborn, and women should be supported in making informed decisions about pain relief without undue concern over potential neonatal complications.