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

Shuai, Fei; Jia, Jun; Lin, Pei

doi:10.1159/000522330

Cited by 7 publications

(5 citation statements)

References 37 publications

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“…Infants born to mothers receiving epidural anesthesia did not have lower Apgar scores, and their acid-base status was more favorable. These results further indicate that labor anesthesia does not result in adverse fetal outcomes [40,41]. However, causal relationships could not be determined from this observational analysis because they were susceptible to residual confounding factors and reverse causality.…”

Section: Discussionmentioning

confidence: 90%

“…While epidural labor anesthesia may prolong the rst and second stages of labor and increase the incidence of fever during labor, it does not increase the rate of cesarean section or postpartum hemorrhage, and has no negative impact on the Apgar scores or neonatal asphyxia rate [39]. Epidural anesthesia can lead to transient maternal hypotension, which may progress to levels requiring uid or vasopressor therapy [40]; however, this is not signi cantly associated with any adverse outcomes, nor is it related to adverse neonatal outcomes. Infants born to mothers receiving epidural anesthesia did not have lower Apgar scores, and their acid-base status was more favorable.…”

Section: Discussionmentioning

confidence: 99%

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Mendelian randomization analysis of the genetic causal relationship between different labor anesthesia methods and adverse neonatal outcomes

Zhang,

Qu,

Wang

et al. 2024

Preprint

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Background Despite the lack of data from randomized controlled trials, studies have indicated that labor anesthesia may be associated with neonatal asphyxia and adverse neonatal neurological outcomes. We used a two-sample Mendelian randomization (MR) study to investigate the causal relationships between different labor anesthesia methods, neonatal asphyxia, and adverse neonatal neurological outcomes. Method We collected genome-wide association study (GWAS) data, including spinal, epidural, and other labor anesthesia methods, as well as neonatal asphyxia and adverse neurological outcomes (cerebral palsy, mental retardation, and attention deficit hyperactivity disorder). Data on different delivery analgesia methods sourced from the Integrative Epidemiology Unit Open GWAS project were used as exposure data. Neonatal asphyxia and neurological adverse outcomes sourced from the FinnGen consortium R10 were used as the outcome data. A two-sample MR was used to evaluate the effects of different delivery analgesia methods on neonatal asphyxia and three adverse neurological outcomes in newborns to determine the existence of a causal relationship between them. The inverse-variance weighted (IVW) method was used for MR analysis and a series of sensitivity analyses were conducted. Results Spinal, epidural, and other methods of labor anesthesia were not associated with neonatal asphyxia (odds ratio [OR]IVW = 1.302, P = 0.749; ORIVW = 1.431, P = 0.622; ORIVW = 0.695, P = 0.688, respectively), cerebral palsy (ORIVW = 0.759, P = 0.480; ORIVW = 0.701, P = 0.319; ORIVW = 0.695, 95% P = 0.688; ORIVW = 1.288, P = 0.523, respectively), intellectual disability (ORIVW = 1.309, P = 0.351; ORIVW = 0.744, P = 0.331; ORIVW = 0.712, P = 0.313, respectively), or attention deficit hyperactivity disorder (ORIVW = 1.163, P = 0.778; ORIVW = 1.012, 95% P = 0.979; ORIVW = 0.972, P = 0.944, respectively). Sensitivity analysis showed no heterogeneity or pleiotropic effects, and the results were reliable. Conclusion Our MR study based on genetic data does not support the existence of a causal relationship between different labor anesthesia methods and neonatal asphyxia or adverse neonatal neurological outcomes. Thus, labor pain relief methods can be selected based on the mother's needs and condition without increasing associated risks.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Mendelian randomization analysis of the genetic causal relationship between different labor anesthesia methods and adverse neonatal outcomes

Zhang,

Qu,

Wang

et al. 2024

Preprint

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“…At present, there are many ways to deliver analgesia during labour, but epidural labour analgesia is still the most widely used, safe and effective way of providing analgesia during labour in the world. It can not only reduce severe pain during childbirth, but also reduce caesarean section rates for non‐obstetric indications, improve neonatal outcomes such as reducing the incidence of neonatal acidosis, neonatal distress and so forth (Harding et al, 2022; Shuai et al, 2022; Wang et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Maternal intrapartum fever during epidural labour analgesia: Incidence and influencing factors

Yuan,

Jin,

Shen

et al. 2023

Int J of Nursing Practice

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BackgroundThe management and nursing care of women's temperature during delivery is an important part of clinical obstetrics. We aimed to evaluate maternal intrapartum fever during epidural labour analgesia to provide evidence for the management and care of women in labour.MethodsThis study was conducted and reported according to the STROBE statement. Women in labour undergoing epidural labour analgesia in our hospital from 1 January 2021 to 31 August 2022 were retrospectively selected. The characteristics of women in labour with and without intrapartum fever were compared. Pearson correlation and logistic regression analysis were used to analyse the influencing factors of postpartum fever.ResultsA total of 196 women in labour were included, the incidence of maternal intrapartum fever in women in labour undergoing epidural analgesia was 27.5%. Pearson correlation analyses showed that BMI, oxytocin use, labour duration, number of vaginal examinations, time from rupture of the foetal membranes to the end of labour and duration of epidural analgesia were all correlated with the occurrence of intrapartum fever (all P < 0.05). Logistic regression analyses indicated that body mass index ≥28 kg/m2(OR = 1.825), oxytocin use (OR = 2.082), labour duration ≥9.2 h (OR = 2.613), number of vaginal examinations ≥8 (OR = 2.044–3.115), the time from rupture of the foetal membranes to the end of labour ≥250 min (OR = 2.766) and duration of epidural analgesia ≥300 min (OR = 3.106) were risk factors for intrapartum fever in women in labour undergoing epidural analgesia (all P < 0.05).ConclusionsMaternal intrapartum fever in women in labour undergoing epidural analgesia is common and influenced by many factors. Nurses should take early preventive care measures according to these factors during epidural analgesia in labour.

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“…We present no data on whether neuraxial analgesia was administered or not. Neuraxial analgesia may have influenced labor and postpartum complications as well as maternal and fetal outcomes [41][42][43]. We did not seek adjusted associations in this descriptive paper, and this should be performed in future research.…”

mentioning

confidence: 99%

Medical and obstetric comorbidities and delivery outcomes in overweight and obese parturients: a retrospective analysis

Gat

Hadar

Orbach‐Zinger

et al. 2023

J Anesth Analg Crit Care

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Background Research on obesity in women of reproductive age is heterogeneous in gestational age and body mass index (BMI) classification and focused mostly on pregnancy-related rather than medical comorbidities. We studied the prevalences of pre-pregnancy BMI, chronic maternal and obstetric comorbidities, and delivery outcomes. Methods Retrospective analysis of real-time data collected during deliveries in a single tertiary medical center. Pre-pregnancy BMI was classified into seven groups (kg/m2): underweight (BMI < 18.5), normal weight 1 (18.5 ≤ BMI < 22.5), normal weight 2 (22.5 ≤ BMI < 25.0), overweight 1 (25.0 ≤ BMI < 27.5), overweight 2 (27.5 ≤ BMI < 30.0), obese (30.0 ≤ BMI < 35.0), and morbidly obese (BMI ≥ 35.0). Data were collected on maternal demographics, chronic medical and obstetric comorbidities, and delivery outcomes. Results Included were 13,726 women aged 18–50 years, with a gestational age of 240/7–416/7 weeks. Pre-pregnancy weights were 61.4% normal, 19.8% overweight, 7.6% obese, and 3.3% morbidly obese. Smoking was more prevalent among morbidly obese than among normal weight women. Obese and morbidly obese women were older and had more diabetes mellitus, hypertension, preeclampsia/eclampsia, and prior cesarean deliveries than normal weight parturients. Obese and morbidly obese women were also less likely to have a non-spontaneous conception, enter labor spontaneously (observed in the full study population and in a subgroup of term parturients), and were more likely to undergo cesarean rather than vaginal delivery. Subgroup analysis of primiparous women yielded similar results. Conclusions We identified a potential association between pre-pregnancy obesity and morbid obesity and higher rates of obstetric comorbidities, less natural conception and spontaneous labor, and more cesarean deliveries and adverse delivery outcomes. It remains to be seen if these findings remain after adjustment and whether they are related to obesity, treatment, or both.

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

Cited by 7 publications

References 37 publications

Mendelian randomization analysis of the genetic causal relationship between different labor anesthesia methods and adverse neonatal outcomes

Mendelian randomization analysis of the genetic causal relationship between different labor anesthesia methods and adverse neonatal outcomes

Maternal intrapartum fever during epidural labour analgesia: Incidence and influencing factors

Medical and obstetric comorbidities and delivery outcomes in overweight and obese parturients: a retrospective analysis

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