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Approved Research

EPIFEVER-2: single nucleotide polymorphisms in the IL-1Ra gene and outcomes in labour following epidural analgesia.

Principal Investigator: Dr Gareth Ackland
Approved Research ID: 62745
Approval date: August 7th 2020

Lay summary

This proposal has been written in partnership with the Barts Research Centre for Women's Health

Research Unit who have provided views on the study from a mixed group of women with varied personal experiences of pregnancy and pregnancy complications, as well as family members, partners and carers attending. Background: up to 3 in 10 women in active labour who choose to have an epidural to make their labour  less painful develop a fever. If women develop a fever during labour, it prompts obstetric doctors to worry that there may be an infection causing the fever, which can cause problems for the baby. Our recent work suggests that the main drug used in epidurals may cause this fever, rather than infection. The drug used for epidurals is called bupivacaine. We think that the drug stops the body making a protein. If the level of this protein is low some women will develop a fever when they are given an epidural with bupivacaine in it. This might affect up to 30,000 women per year. These women may need extra help during labour such as surgery or forceps to deliver their baby. These women are also more likely to receive antibiotics when they don't need them. Antibiotics may cause side effects in either the mother or baby.

Aims: the project aims  to identify women who may be genetically programmed to have more complicated labour  if they choose an epidural. By identifying this group of women, we may be able to make their labours more comfortable and less stressful by knowing their risk of having more complicated labours if they choose to have an epidural.

Methodology: We will compare how many women get a fever after epidural in relation to their genetic differences for the "anti-fever" gene Expected outcomes: We will see if we can predict women who may develop fever after having an epidural in labour.

Implications: The practical implications of our study results will enable doctors and midwives to advise women with more information to guide the best options for pain relief during labour.