Epidural-Related Maternal Fever Is Associated With Structural Alterations in Vaginal Floral Homeostasis Among Parturients.

Objective: To explore the association between epidural-related maternal fever (ERMF) and maternal vaginal microbiota, as well as its potential association with early infant neurodevelopment. Methods: This study enrolled pregnant women who underwent vaginal delivery with epidural analgesia. According to the presence or absence of intrapartum fever (body temperature ≥ 37.5 °C), the participants were divided into either the control group or the fever group. Multiple vaginal swabs were collected from the parturients for further analysis using 16S rRNA amplicon sequencing. The general conditions of both mothers and neonates were recorded. At three months postpartum, infants' neurodevelopmental status was assessed using the Ages and Stages Questionnaires, Third Edition (ASQ-3). Results: Analysis of the vaginal flora demonstrated that Lactobacillus was the dominant genus in both groups. ERMF was not associated with significant changes in the overall alpha diversity of the vaginal microbiota ( Conclusion: ERMF is associated with alterations in the structural composition of vaginal microbiota and dysregulation of specific bacterial genera. Labor duration is significantly associated with early infant ASQ-3 scores. However, this exploratory study has several limitations-including a relatively small sample size and a short follow-up duration-which preclude definitive conclusions regarding a causal or direct association between ERMF exposure and early infant neurodevelopment. Additional rigorously designed longitudinal studies are warranted to further elucidate and validate this relationship.