Factors associated with women’s preferences for labor epidural analgesia in Singapore: a survey approach

Abstract

Epidural analgesia provides effective pain relief during labor. However, there is limited information on the factors associated with pregnant women’s preferences for labor epidural analgesia (LEA) prior to labor onset. We performed a secondary analysis of a clinical trial to identify demographic characteristics, pain and psychological vulnerability factors associated with preferences for LEA. Pregnant women at ≥ 36 weeks’ gestation prior to labor and delivery were recruited and given questionnaires on their LEA preferences, psychological and pain vulnerabilities. The primary outcome was the association between pre-delivery Edinburgh Postnatal Depression Scale (EPDS) with cut-off ≥ 10 and LEA preference. Of the 250 women recruited, 51.6% (n = 129) indicated “yes to LEA”. Amongst those considering LEA as an option to reduce labor pain, women who preferred to use LEA (n = 129) indicated favorable or neutral opinion. Additionally, 68% (n = 82) from those “no to LEA” or “not sure about LEA” still gave either favorable or neutral opinion for LEA (p < 0.0001). The multivariate logistic regression analysis found that EPDS ≥ 10 (p < 0.01), occupation (p = 0.03), ethnicity (p < 0.01), state anxiety (p = 0.02), mode of current pregnancy (unplanned; planned, assisted; planned, natural; p = 0.03) and premenstrual anger/irritability before current pregnancy (p = 0.02) were associated with LEA preference. The findings may help to define the population that may require further education on considering LEA and allow early identification on different LEA preferences to provide patient centric care prior to labor and delivery.

Sub-acute pain after childbirth during COVID-19 pandemic: A secondary analysis of A prospective clinical trial

“…Upon informed consent, patients would fill in a set of questionnaires before their delivery, which comprised questions on labor pain and psychological vulnerability that were validated and used in Singaporean pregnant women [ 10 , 11 ], including the following. Edinburgh Postnatal Depression Scale (EPDS): A self-reporting scale consisting of 10 items of antenatal and postnatal depression with a score ranging from 0 to 30 [ 12 ].…”

Investigating the association factors of acute postpartum pain: a cohort study

“…The quantitative associations derived from the logistic regression models were expressed as odds ratio (OR) with corresponding 95% confidence interval (95% CI). Variables with p < 0.15 with less than 10% of missing data in the univariate logistic regression analysis and clinically relevant were chosen for the subsequent multivariable logistic regression analysis [ 15 , 19 ]. Stepwise variable selection method was used to finalize the final multivariable model.…”

Analgesia Medicamentosa No Momento Do Parto

“…Além disso, a analgesia epidural pode beneficiar mulheres com gestações de alto risco, como pré-eclâmpsia, devido à sua capacidade de reduzir a hipertensão relacionada à dor e os níveis de catecolaminas, melhorando potencialmente o fluxo uteroplacentário. No entanto, apesar das vantagens da analgesia epidural, muitas mulheres expressaram preocupação com seus potenciais efeitos adversos, incluindo trabalho de parto prolongado, necessidade de parto instrumental e dor nas costas (TAN et al, 2022).…”