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

Abstract

Objectives: The aim of the study was to estimate the impact of epidural analgesia (EA) during delivery on maternal and infant outcomes.

Design: This was a prospective cohort study.

Participants: In total, 159 pregnant multiparas in Women and Children's Hospital, School of Medicine, Xiamen University from November 2019 to May 2020 were enrolled. Patients were divided into the EA group (n = 80) and no analgesia group (n = 79) based on the choice of the parturients.

Methods: The duration of labor, levels of umbilical arterial blood gas (pH and partial pressure oxygen), visual analog score (VAS), and adverse events were evaluated to compare differences between the EA group and no analgesia group, respectively.

Results: The duration of labor was prolonged in the entire labor (p = 0.002), and the first stage (p = 0.001) in the EA group compared with the no analgesia group. The second stage of labor and third stage of labor, levels of umbilical arterial blood gas, and 1-min Apgar score in neonates were similar in EA and no analgesia groups (All p > 0.05). After adjusting age, prepregnancy body mass index, and past and present medical history, the VAS was low in the EA group compared with the no analgesia group when the uterine orifice was completely open (odds ratio [OR] = 0.001, 95% confidence interval [CI]: 0.001-0.002), 8 h postdelivery (OR = 0.508, 95% CI: 0.264-0.977), and 24 h postdelivery (OR = 0.321, 95% CI: 0.167-0.617). EA increased the proportion of adverse events occurring 5 min postdelivery (χ2 = 10.137, p = 0.001), while decreased the proportion of adverse events occurring 24 h postdelivery (χ2 = 4.750, p = 0.029).

Limitations: In terms of the effects of EA on neonates, we only measured the 1-min Apgar score of neonates.

Conclusions: EA might be a reliable pain relief method for pregnant women. The results of our study might give a reference for the use of EA during delivery in clinic.

Keywords: Delivery; Epidural analgesia; Infant outcomes; Maternal outcomes.