Comparison between neonatal outcomes of labor and delivery with labor neuraxial analgesia and without analgesia: A propensity score‐matched study

Watanabe, Kaede; Sakamaki, Daisuke; Shiko, Yuki; Kawasaki, Yohei; Noguchi, Shohei; Mazda, Yusuke

doi:10.1111/jog.15571

Cited by 3 publications

(1 citation statement)

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“…In multiparas, combined spinal-epidural analgesia (CSEA) provided superior analgesia and satisfaction compared to remifentanil patient-controlled analgesia (RPCA) [ 26 ]. After propensity score matching, Watanabe K and colleagues discovered that the nulliparous NA group exhibited a notably higher incidence of Apgar scores of 7 at both 1 and 5 min and had increased occurrences of meconium-stained amniotic fluid, while no significant difference in neonatal outcomes were observed in multiparous women [ 27 ]. Our study found that there was no significant difference in the amount and rate of PPH, the rate of transferred to ICU, postpartum stay ≥ 7d, the Apgar score at 1 and 5 min, the rate of neonatal transfer to NICU and the rate of meconium-stained amniotic fluid among the no-NA, early-NA and the late-NA multiparous women.…”

Section: Discussionmentioning

confidence: 99%

Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study

Cheng,

Xiong,

et al. 2024

BMC Anesthesiol

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Background The mechanism underlying maternal fever and prolonged labor progression associated with neuraxial analgesia (NA) remains elusive, raising concerns among certain pregnant women regarding the application of NA during vaginal delivery. This study aimed to investigate the impact of early and late NA on maternal and neonatal outcomes in multiparous women. Methods This retrospective study collected data from 1119 multiparous women with singleton pregnancies, full term and live births at our labor and delivery center between August 1st, 2021 and July 31st, 2022. Based on the timing of NA initiation, participants were categorized into three groups: no-NA, early-NA and late-NA. The no-NA group comprised of 172 women who did not receive NA during vaginal delivery; the early-NA group included 603 women in which NA was initiated when cervical dilation was between 0.5 and 2.0 cm; and the late-NA group comprising 344 cases in which NA was initiated at the cervical dilation of ≥ 2 cm. Maternal and neonatal outcomes were observed, including durations of the first, second, third and total stage of labor, the rate of intrapartum cesarean delivery (CD), intrapartum fever, postpartum hemorrhage (PPH), transfer to intensive care unit (ICU), admission to the neonatal intensive care unit (NICU), meconium-stained amniotic fluid, and neonatal Apgar scores at 1 and 5 min. Results No differences were noted in the maternal age, body mass index (BMI) on admission, gestations, parity, gestational weeks at delivery and neonatal birth weight, or the rate of gestational diabetes mellitus (GDM) and hypertension disorder did not significantly differ among the three groups (p > 0.05). The no-NA group had shorter durations of first stage, second stage of labor compared to the early-NA or late-NA group (median, 215.0 min and 10.0 min vs. 300.0 min and 12.0 min vs. 280.0 min and 13.0 min) (p < 0.05), but no differences were observed between the early-NA and late-NA group (p > 0.05). There were no differences in the rate of intrapartum CD, intrapartum fever, PPH, maternal transferred to ICU, neonatal transfer to NICU, meconium-stained amniotic fluid, and postpartum stay ≥ 7d, as well as the neonatal the Apgar scores at 1 and 5 min among the three groups (p > 0.05). Conclusion NA is associated with extended durations of the first, second and total stages of labor. However, the early initiation of NA in multiparous women (cervical dilation within 0.5-2.0 cm) does not increase the risk of intrapartum CD or intrapartum fever. These findings endorse the secure utilization of early NA for pain relief during labor in multiparous women.

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Section: Discussionmentioning

confidence: 99%

Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study

Cheng,

Xiong,

et al. 2024

BMC Anesthesiol

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Analgesia neuroaxial no trabalho de parto: efeitos sobre desfechos maternos e neonatais

Souza,

Carneiro,

Farias

et al. 2024

Acta paul. enferm.

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Resumo Objetivo Comparar os desfechos maternos e neonatais de mulheres que usaram e não usaram analgesia neuroaxial durante o trabalho de parto. Métodos Estudo transversal comparativo, documental, com coleta retrospectiva de dados, realizado em uma maternidade terciária de referência no Ceará. O tamanho da amostra foi calculado pela diferença entre duas proporções: partos vaginais com e sem analgesia, sendo 130 mulheres para cada grupo, totalizando 260 prontuários. A coleta de dados ocorreu entre julho de 2019 e fevereiro de 2020. Foram usados os testes t de Student, U de Mann-Whitney, qui-quadrado de Pearson, exato de Fisher e o programa IBM SPSS. Resultados O grupo com analgesia apresentou maior média de consultas pré-natal (8,24; p<0,001), maior exposição à indução (74; 56,9%; p<0,001), com uso de ocitocina (57; 43,8%; p<0,001), maior duração do trabalho de parto ativo (média: 392 min; p<0,001) e do período expulsivo (média: 85,3 min; p<0,001), maior frequência de episiotomia (7; 7,9%; p=0,03), de parto cesárea (41; 31,5%; p<0,001), e pariram bebês mais pesados (média: 3,28 kg; p=0,007). Conclusão O uso de analgesia está associado à maior frequência de intervenções obstétricas, bem como ao aumento na duração do trabalho de parto. Quanto aos desfechos neonatais, o grupo com analgesia pariu recém-nascidos mais pesados; além disso, não foi observada associação com o escore de Apgar, nem encaminhamentos para unidades de risco.

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Neuroaxial analgesia in labor: effects on maternal and neonatal outcomes

Souza,

Carneiro,

Farias

et al. 2024

Acta paul. enferm.

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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.

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Comparison between neonatal outcomes of labor and delivery with labor neuraxial analgesia and without analgesia: A propensity score‐matched study

Cited by 3 publications

References 25 publications

Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study

Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study

Analgesia neuroaxial no trabalho de parto: efeitos sobre desfechos maternos e neonatais

Neuroaxial analgesia in labor: effects on maternal and neonatal outcomes

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