(1096) Race and Temporal Temperature Measurement in Intraamniotic Infection

Temperature is underestimated in Black versus White inpatients when temporal thermometers are used. There is no data on racial differences in temporal temperature measurements in obstetrical patients in assessment of Intraamniotic infection (IAI). Our aim was to analyze intrapartum temporal temperature readings in self-identified Black versus White patients with IAI.  We hypothesized that Black patients would have significantly lower max temperature (Tmax) when measured temporally and this may result in delay of diagnosis or antibiotics, higher stage or grade of chorioamnionitis on pathology or neonatal and maternal morbidity.

Study Design:

We conducted a single institution retrospective cohort study of self-identified Black and White patients at term with clinical IAI or histopathological diagnosis of chorioamnionitis from 2021-2022. Primary outcomes were differences in Tmax in Black versus White patients with clinically diagnosed IAI and Tmax differences in Black versus White patients with histopathological chorioamnionitis.  All temperatures were measured with temporal thermometers. Secondary outcomes included differences in stage and grade of chorioamnionitis, timing of diagnosis and antibiotics, and neonatal and maternal complications.

Results: 459 patients were identified that met the inclusion and exclusion criteria, 285 (62.1%) Black patients and 174 (37.9%) White patients, with Black patients more likely to be diagnosed with IAI. Black patients were younger, more often multiparous, with higher BMIs and a higher likelihood of hypertensive diseases. There was no difference in primary outcome of Tmax by race. Black patients with a clinical diagnosis of IAI were more likely to undergo cesarean delivery. Infants of White patients with a histopathological diagnosis of chorioamnionitis were more likely to be admitted to the NICU.

Conclusion: Temporal thermometer measurements were not statistically significant by race.  However there were disparities in cesarean delivery rates and NICU admissions.