Recurrent fever in pregnant women

Recurrent fever in pregnant women: Searching for the hidden cause

Recurrent, or periodic, fever during pregnancy is a condition characterized by repeated episodes of high temperature alternating with periods of normal well‑being. It is always a concerning symptom that requires careful diagnostic investigation, as it may indicate an underlying chronic disease that could be activated by the immune changes of pregnancy.

Possible causes of periodic fever

The causes can be very diverse, ranging from infectious to autoimmune.

• Chronic infections:
  • Chronic pyelonephritis: A kidney infection that can have periodic exacerbations. This is especially relevant for pregnant women due to physiological changes in the urinary system, as described in the article about UTI in pregnancy.
  • Hidden infection foci: Chronic tonsillitis, sinusitis, dental problems.
  • Specific infections: Such as tuberculosis or brucellosis, which can present with wave‑like fever.
• Autoimmune diseases: Pregnancy can trigger the onset or flare of systemic connective‑tissue diseases (e.g., systemic lupus erythematosus), one of whose manifestations is fever.
• Autoinflammatory syndromes: Rare genetic disorders characterized by periodic inflammatory attacks.

Diagnostic approach

Diagnosis requires a comprehensive approach. A meticulously collected medical history and a temperature diary, recording the frequency, duration, and accompanying symptoms of each episode, are of great importance. The physician will order extensive blood and urine tests, bacterial cultures, and, if needed, consultations with specialists (infectiologist, rheumatologist). If the cause remains unclear, the condition may be classified as fever of unknown origin.