Epidural analgesia use during labour in maternity hospitals across China: A prospective case-control questinnaire survey

Abstract

Background Specialised maternity hospitals respond to over 90% of labour analgesia requests in their localities within China. We administered a questionnaire survey to determine the predictors of labour analgesia use in two of these hospitals, with the aim of further enhancing epidural analgesia utilisation during labour. Methods This prospective case-control multi-centre questionnaire survey included a total of 640 postpartum women with 374 women who received epidural analgesia and 266 women who did not receive epidural analgesia. The questionnaire contained 20 questions and was distributed through WeChat from July 2022 to September 2022. The responses to the questionnaires were uploaded to the cloud storage space, and only the statistician had access to the original data. Multivariate logistic regression analysis was used to screen variables related to the receipt of epidural labour analgesia. Binary logistic regression was used to identify predictors related to the administration of epidural labour analgesia from a set of selected variables. Results Binary logistic regression results of the survey data showed that multi-parity (odds ratio [OR] 2.805, 95% confidence interval [CI] 1.792 to 4.393, P < 0.001), late arrival of anaesthesiologist (OR 2.728, 95% CI 1.180–6.306, P = 0.019), and rapid progress in first stage of labour (OR 11.709, 95% CI 7.449–18.404, P < 0.001) prevented women from receiving epidural labour analgesia, while women’s preference (OR 0.035, 95% CI 0.013–0.097, P < 0.001) and family agreement to epidural analgesia prior to labour (OR 0.091, 95% CI 0.016–0.551, P = 0.006) promoted its use. Conclusions To address the factors that may hinder or promote the use of epidural labour analgesia in maternal specialised hospitals, pregnant women should be screened for the risk of rapid progression in the first stage of labour and be provided latent-phase labour analgesia. Moreover, in cases where anaesthesiologists are unavailable or when women have contraindications to epidural analgesia, inhalation nitrous oxide analgesia and intravenous remifentanil analgesia should be considered as alternative options. It is recommended that hospitals provide professional, comprehensive, and free antenatal education on labour analgesia to pregnant women and their families to further promote the use of epidural analgesia. Trial registration: http://www.chictr.org.cn ChiCTR2200055621; January 15, 2022.