Abstract
Background
In general, epidural analgesia is considered a safe and efficient way to relieve pain
during active labour and is increasingly used in childbirth. It is well documented
that epidural analgesia during birth has benefits but also adverse effects. However,
evidence is limited on how epidural analgesia influences neonatal outcome in a low-risk
population of birthing women.
Aim
To examine low Apgar score, foetal hypoxia and admission to the neonatal intensive
care unit in neonates of low-risk women receiving epidural analgesia during birth.
Methods
A cohort study using registry data to investigate a population of 23,272 low-risk
women giving birth at a university hospital.
Results
Epidural analgesia was used in 21.6% of low-risk women during birth. Low Apgar score,
foetal hypoxia, and admission to the neonatal intensive care unit were found in 0.6%,
0.6%, and 10.0%, respectively in neonates of mothers receiving epidural analgesia
during birth compared to 0.3%, 0.6%, and 5.6%, respectively in the non-exposed group.
Epidural analgesia was associated with low Apgar score, adjusted odds ratio 1.76 (95%
CI 1.07–2.90) and admission to the neonatal intensive care unit, adjusted odds ratio
1.43 (95% CI 1.26–1.62). A mediation analysis indicates the impact of epidural analgesia
on adverse neonatal outcomes was mediated by obstetric complications like maternal
fever, labour augmentation, and foetal malpresentation.
Conclusion
This study found use of epidural analgesia during birth in low-risk pregnant women
was associated with infant low Apgar score and admission to the neonatal intensive
care unit.
Keywords
Abbreviations:
EA (epidural analgesia), BMI (body mass index), NICU (neonatal intensive care unit), PROM (prelabour rupture of membranes)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 18, 2020
Accepted:
May 19,
2020
Received in revised form:
May 12,
2020
Received:
November 26,
2019
Identification
Copyright
© 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
