Epidural analgesia during birth and adverse neonatal outcomes: A population-based cohort study

Høtoft, Diana; Maimburg, Rikke Damkjær

doi:10.1016/j.wombi.2020.05.012

Cited by 15 publications

(14 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most of the studies included in the review compared EDA with opioids. However, more recent studies report an association between EDA and increased risk of low Apgar score and admission to neonatal care ( Høtoft and Maimburg, 2020 ;Ravelli et al, 2020 ). Additionally, it has been reported that EDA can have an adverse effect on breastfeeding.…”

Section: Introductionmentioning

confidence: 99%

Epidural use among women with spontaneous onset of labour – an observational study using data from a cluster-randomised controlled trial

Lindgren

Rådestad

Pettersson³

et al. 2021

Midwifery

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Epidural use among women with spontaneous onset of labour – an observational study using data from a cluster-randomised controlled trial

Lindgren

Rådestad

Pettersson³

et al. 2021

Midwifery

View full text Add to dashboard Cite

“…3 ). Though a latest Cochrane reviewed comprising 40 trials found that labor epidural analgesia have not an immediate effect on neonatal status as determined by Apgar scores or in admissions to neonatal intensive care [ 17 ], the use of epidural analgesia was associated with higher odds of low Apgar scores and admission to the neonatal intensive care unit [ 3 , 12 ]. Because those studies were only for nulliparous women, there is a need to draw critical attention to evaluate the use of labor epidural analgesia in multiparous women with impacts on neonatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Epidural analgesia effectively relieves the pain during the progress of labor, but it is still not available consistently in many institutions. Though the rate of epidural analgesia using has been increased in China, nearly 57 % in some institutions recently [ 1 ], only 4 % of total women and 21.6 % of low-risk women received labor epidural analgesia in the whole world [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Labor epidural analgesia versus without labor epidural analgesia for multiparous women: a retrospective case control study

et al. 2021

View full text Add to dashboard Cite

Background Labor epidural analgesia (LEA) effectively relieves the labor pain, but it is still not available consistently for multiparous women in many institutions because of their obviously shortened labor length. Methods A total of 811 multiprous women were retrospective enrolled and firstly divided into two groups: LEA group or non-LEA group. And then they were divided into seven subgroups and analyzed according to the use of LEA and cervical dilation. The primary outcomes (time intervals, blood loss and Apgar scores) and secondary outcomes (maternal demographic characteristics and birth weight) were collected by checking electronic medical records. Results The prevalence of using LEA in multiprous women was 54.5 %. Using LEA significantly lengthened the duration of labor stage by 56 min (P < 0.001), increased the blood loss (P < 0.001) and lowered Apgar scores (P = 0.001). In the comparison of sub-group analysis, using LEA can obviously prolong the duration of first-second stage in women with 2 cm cervical dilation (P < 0.001) and 3 cm cervical dilation (P = 0.014), while there was no significant difference with 4 cm or more cervical dilation (P = 0.69). Using LEA can significantly increased the blood loss when the initiation of LEA in the women with 2 cm cervical dilation (P < 0.001) and 3 cm cervical dilation (P = 0.035), meanwhile there were no significantly differences in the women with 4 cm or more cervical dilation (P = 0.524). Using LEA can significantly lower the Apgar scores when the initiation of LEA in the women with 2 cm cervical dilation (P = 0.001) and 4 cm or more cervical dilation (P = 0.025), while there were no significantly differences in the women with 3 cm cervical dilation (P = 0.839). Conclusions Labor epidural analgesia for the multiparous woman may alter progress of labor, increase postpartum blood loss and lower Apgar scores. Early or late initiation of LEA should be defined as with cervical dilatation of less or more than 3 cm and the different effect should be understand. Trial registration ChiCTR2100042746. Registered 27 January 2021-Prospectively registered, http://www.chictr.org.cn.

show abstract

“…Moreover, EA has been found to increase the rates of instrumental vaginal delivery and cesarean section [15]. A lower Apgar scores and increased risks of neonatal hypoxia and neonatal encephalopathy in fetuses were identified in patients using EA during labor [16]. Several other studies also demonstrated that there was no a cause-effect link between EA and prolonged stage of labor, lower Apgar scores, and increased the risks of neonatal hypoxia [17, 18].…”

Section: Introductionmentioning

confidence: 99%

Effects of Using Epidural Analgesia during Delivery on Maternal and Infant Outcomes

Shuai

Jia

Lin³

2022

Gynecol Obstet Invest

View full text Add to dashboard Cite

Objectives: To estimate the impact of epidural analgesia (EA) during delivery on maternal and infant outcomes. Design: This study was a prospective cohort study. Participants: In total, 159 pregnant women in Women and Children’s Hospital, School of Medicine, Xiamen university from Nov. 2019 to May 2020. Patients were randomly divided into EA group (n=80) and no analgesia group (n=79). Methods: The duration of labor, levels of umbilical arterial blood gas [pH and partial pressure oxygen (PaO2)], VAS, adverse events were evaluated to compare differences between EA group and no analgesia group, respectively. Results: The duration of the first stage of labor was shorted in the total stage (P=0.002) and the first stage of labor (P=0.001) in EA group compared with no analgesia group. The second stage of labor and third stage of labor, levels of umbilical arterial blood gas and 1min Apgar score in neonates were similar in EA and no analgesia groups (All P>0.05). After adjusting age, pre-pregnancy BMI, and past and present medical history, the VAS was low in EA group compared with no analgesia group when the uterine orifice was completely open [odds ratio (OR)=0.001, 95% confidence interval (CI):0.001-0.002], 8h post-delivery (OR=0.508, 95%CI:0.264-0.977) and 24h post-delivery (OR=0.321, 95%CI:0.167-0.617). EA increased the proportion of adverse events occurring 5 min post-delivery (χ2=10.137, P=0.001), while decreased the proportion of adverse events occurring 24h post-delivery (χ2=4.750, P=0.029). Limitations: In terms of the effects of EA on neonates, we only measured the 1 min Apgar score of neonates. Conclusions: EA might be a promising pain relief method for pregnant women. The results of our study might give a reference for the use of EA during delivery in clinic.

show abstract

Epidural analgesia during birth and adverse neonatal outcomes: A population-based cohort study

Cited by 15 publications

References 34 publications

Epidural use among women with spontaneous onset of labour – an observational study using data from a cluster-randomised controlled trial

Epidural use among women with spontaneous onset of labour – an observational study using data from a cluster-randomised controlled trial

Labor epidural analgesia versus without labor epidural analgesia for multiparous women: a retrospective case control study

Effects of Using Epidural Analgesia during Delivery on Maternal and Infant Outcomes

Contact Info

Product

Resources

About