Can Red Light Therapy Reduce Epidural Fever?
About 20% of women experience an increase in body temperature during labor with an epidural. It's just one of those things to keep in mind as you prepare for the big day. But if you’re a red light therapy fan and also planning an epidural it might be worth taking your tools into hospital with you. Fevers can make providers ‘twitchy’ as it’s often associated with infection so there can be pressure to get baby out sooner - so having some tools to reduce your chances of developing a temperature in labor might be the ticket.
A current idea is that ERMF (epidural related maternal fever) is an inflammatory reaction that’s not caused by infection. Instead, it's triggered by certain molecules released when cells are damaged. These molecules can activate something called the inflammasome, which kicks off the body’s inflammatory response. (So it’s likely you don’t have an infection but you may be under pressure to accept an accelerated labor with Pitocin or even a cesarean birth).
Anesthetics Activate Your Immune System
Interestingly, studies in the lab have shown that local anesthetics, like the ones used for pain relief, can affect the immune system and damage cells by messing with the mitochondria—the energy producers in our cells. This damage leads to the release of lots of reactive oxygen species (ROS), which are harmful molecules that cause inflammation by producing things like cytokines and prostaglandin E2 (also causing more pain)!
When mitochondria are stressed, they release mitochondrial DNA (mtDNA) into the space outside the cell. This release isn’t just accidental; it can be a regulated process. Research has shown that changes in cell-free mtDNA in the blood can indicate mitochondrial damage. While studies have found mtDNA issues in preeclampsia, no previous studies in humans has yet looked at the link between mtDNA changes and ERMF. Lab experiments have shown that local anesthetics like bupivacaine and ropivacaine can affect mitochondrial function, cause ROS generation, and even promote cell death in a dose-dependent manner.
So, this pilot study aimed to explore changes in plasma cell-free mtDNA levels in women in labor with ERMF compared to women in labor with epidural analgesia without a fever and women without epidurals.
What the Researchers Found:
Labor duration was significantly longer in women with epidural analgesia (p < 0.01) but not in women who developed a fever. Premature rupture of membranes (PROM) was more often present in women with fever (55%) compared to women with epidural analgesia without fever (21%) and women without epidural analgesia (6%). A significantly increased temperature was detected in subjects with ERMF 8 h after the start of the study.
A significant release of IL-6 (Interleukin-6) was present in the blood in women with epidural analgesia (p < 0.01), as well as in ERMF (p < 0.01) at birth. Other inflammatory cytokines, such as IL-1ß, IL-8 and PGE2, demonstrated no significant changes.
The authors didn't see an increase in plasma mtDNA levels in women with ERMF. However, there was a noticeable difference in mtDNA regulation. Women with ERMF had lower levels of circulating cell-free mtDNA during labor, which was statistically significant. Interestingly, there was also a trend (though not significant) towards higher levels of cell-free nDNA. This pattern is somewhat similar to what Cushen et al. observed in women with preeclampsia, but not as pronounced. This might be because our ERMF group had fewer participants.
So, in this study women who developed a fever with the epidural had lower levels of those special molecules. We know from years of research that red light therapy helps our mitochondria work more effectively while also reducing inflammation in the body - might be worth a shot at keeping your labor as normal as possible (bring your red light devices and your doula!).
Resources:
https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06551-7
