Objective
Clinical chorioamnionitis is associated with an increased risk for major neurologic disabilities in children such as cerebral palsy. There is little data on other neurobehavioral outcomes. We examined whether more subtle behavioral outcomes in early childhood differ based on the presence or absence of intrapartum fever.

Study design
Subjects were identified from women enrolled in the national multicenter longitudinal Fragile Families and Child Wellbeing Study. This is a cohort study of women recruited from 20 cities (populations >200,000) delivering in 75 hospitals across the United States. Women delivering in the context of the Fragile Family (unwed) were over sampled and were enrolled at the time of delivery. Subjects were contacted 3 years after the delivery for a follow-up evaluation. Standard tests of behavioral, emotional and cognitive development were administered, which included the Achenbach Child Behavior Checklist and the Peabody Picture Vocabulary Test-III (PPVT). Measures of child behavior and function were compared based on the presence or absence of intrapartum fever. Analyses (odds ratios, OR) were adjusted for maternal age, race, parity, smoking, marital status and child's age in months.

Results
Of the 2058 subjects studied, 8% (168) had an intrapartum fever. There were non-significant trends for children from intrapartum fever cases to be more withdrawn, with more withdrawal scores that were >75th centile (OR 1.56, P=0.13), fewer aggressive behavior scores that were >75th centile (OR 0.58, P=0.18) and lower PPVT scores (P=0.15). Scores for anxiety/depression, problematic behavior, and cruelty to animals were similar. Results were unchanged when stratified on gestational age (term, preterm <37 weeks and preterm <32 weeks).

Conclusion
There were no clear patterns of problems with behavioral, emotional and cognitive development in children born to mothers with intrapartum fever when assessed at 3 years of age. Additional follow-up will help determine whether other findings develop as these children grow older.