Neuroaxial analgesia in labor: effects on maternal and neonatal outcomes

Abstract

Objective To compare maternal and neonatal outcomes of women who used and did not use neuraxial analgesia during labor. Methods A cross-sectional, comparative, documentary study, with retrospective data collection, carried out at a tertiary reference maternity hospital in Ceará. Sample size was calculated by the difference between two proportions: vaginal births with and without analgesia, with 130 women for each group, totaling 260 medical records. Data collection took place between July 2019 and February 2020. Student’s t test, Mann-Whitney U test, Pearson’s chi-square test, Fisher’s exact test and the IBM SPSS program were used. Results The group with analgesia had a higher mean number of prenatal consultations (8.24; p<0.001), greater exposure to induction (74; 56.9%; p<0.001), with use of oxytocin (57; 43.8%; p<0.001), longer duration of active labor (mean: 392 min; p<0.001) and expulsive period (mean: 85.3 min; p<0.001), higher frequency of episiotomy (7; 7.9%; p=0.03), by cesarean section (41; 31.5%; p<0.001), and heavier babies were born (mean: 3.28 kg; p=0.007). Conclusion The use of analgesia is associated with a greater frequency of obstetric interventions as well as an increase in the duration of labor. Regarding neonatal outcomes, the group with analgesia gave birth to heavier newborns; Furthermore, no association was observed with the Apgar score, nor referrals to high-risk units.