Sociodemographic factors associated with request for labor epidural analgesia in a tertiary obstetric hospital in Vietnam

Abstract

Background Labor epidural pain relief remains underutilized in developing countries and may serve as a marker of health care access disparity. Here we examine the sociodemographic factors associated with the utilization of labor epidural analgesia at a large obstetrics and gynecology hospital in Vietnam.Methods This was a cross-sectional study of women who underwent vaginal delivery in September 2018 at the Hanoi Obstetrics and Gynecology Hospital. Utilization of epidural analgesia during labor was determined. Univariate and multivariate regression models were applied to evaluate the association between patient demographic and socioeconomic factors and request for labor epidural analgesia.Results A total of 417 women had vaginal deliveries during the study period. 207 women (49.6%) utilized epidural analgesia for pain relief during labor and 210 did not. Parturients more likely to utilize labor epidurals were older than 35 years of age (OR 2.84, 95% CI 1.11-8.17), multiparous (OR 2.8 95% CI 1.85-4.25), from an urban area, with higher income (OR 6.47, 95% CI 2.59-19.23), and with higher level of education.ConclusionsFactors related to a parturient’s request for epidural analgesia during labor at our tertiary obstetric hospital included include age greater than 35 years, multiparity, and high income and education levels. Educational outreach to women about the benefits of epidural analgesia can target women who do not share these demographics.

Factors associated with demand for epidural analgesia among women in labor at a tertiary hospital in Nnewi, South-East, NigeriaFactors associated with demand for epidural analgesia among women in labor at a tertiary hospital in Nnewi, South-East, Nigeria

“…Our study further noted that educated women dominated the demand for epidural analgesia because they are better informed about the trending events especially as it concerns their reproductive health. This submission therefore suggests that their knowledge of epidural technique for labor pains could have contributed to the level of demand observed which corroborated the reports of other authors [10][11][12][13].Additionally, parturients who utilized labour epidurals were significantly older than 30 years of age (p=0.002), multiparous (p=0.001), and were higher income earners (p=<0.001) This was in consistent with previous Vietnam Study [1]. .Apart from the knowledge of labor epidural analgesia, a few other concerns had continued to challenge its wide use in our setting which included the effect of epidural analgesia on the outcome of labor in terms of progress of labor, mode of delivery and backache.…”

“…Maternal childbirth care is one of the main indices of development of any nation and this could be gauged best by the type of labor analgesia she receives during pregnancy and childbirth [1][2][3]. Child birth unarguably is a desirable event but has been described as the most painful, emotionally and physically distressing experience affecting the mother, fetal wellbeing as well as progress of labor [2,3].…”

Awareness among Pregnant Women about Epidural Analgesia: A Cross-Sectional Study

“…In addition, we studied the factors that could influence participants' desire to receive EPA during labor and found that women with higher levels of education were more likely to request EPA during delivery, which was consistent with a previous study conducted in Vietnam [12]. Similarly, a study carried out in the United States revealed a significant association between the level of education and epidural request [13].…”

“…Factors such as employment were associated with the request of the epidural analgesia in a study conducted in Riyadh [8], which was inconsistent with our results. A couple of studies found that expectant mothers with health insurance were more likely to request EPA during labor [12,14]. In contrast, in our study, financial factors did not contribute to decision-making because our study setting was in a government hospital where free health care is provided.…”

Ensaio clínico randomizado sobre o impacto da analgesia de parto nos níveis séricos de catecolaminas, frequência cardíaca fetal e tônus uterino em gestantes com comorbidades

“…Em 1981 foi criada a técnica de bloqueio combinado (11), a qual vem ganhando crescente popularidade durante os últimos anos. Cerca de 75-80% das parturientes no Reino Unido, 75% das mulheres francesas e 73% das americanas recebem bloqueio de neuroeixo para alívio da dor (12)(13)(14), embora taxas mais baixas possam ser encontradas a depender do serviço de saúde, paridade prévia, grau de instrução da paciente ou até mesmo devido a diferenças culturais entre os países (15,16). No Brasil, apenas 16% das pacientes atendidas no serviço público e cerca de 50% atendidas no serviço privado recebem analgesia neuroaxial (17).…”