Epidural analgesia for labor: effects on length of labor and maternal and neonatal outcomes

Abstract

Objective: The aim of the study was to investigate the impact of epidural analgesia on the stages of labor and maternal and neonatal outcomes.

Patients and methods: A retrospective cohort study was conducted in the First Affiliated Hospital of Guangxi Medical University from January 1, 2020 to September 30, 2020. A total of 472 parturient met the inclusion criteria. Of them, 246 parturients received labor analgesia and 226 did not (control group). Their general characteristics, the length of labor, adverse reactions to analgesia, and maternal and neonatal outcomes between the two groups were compared to analyze and evaluate the feasibility of epidural analgesia in labor.

Results: (1) The women in the analgesia group experienced a significantly longer (p<0.001) 1st stage, 2nd stage, and total stage during labor; (2) the usage rate of oxytocin, the rate of external cephalic version, and the success rate of external cephalic version were all significantly higher in the analgesia group (p<0.001); (3) there was no statistically significant difference between the vaginal delivery rate and transit cesarean section rate of the two groups; (4) compared with the control group, the incidence of intrapartum fever was significantly increased in the analgesia group (p<0.05); (5) there was no statistically significant difference between the two groups in postpartum hemorrhage, neonatal Apgar score, and neonatal asphyxia rate.

Conclusions: (1) Labor analgesia may prolong the 1st and 2nd stages of labor and increases the incidence of intrapartum fever, without increasing the rate of transit to cesarean section and postpartum hemorrhage; (2) labor analgesia does not negatively affect the Apgar score or increase the neonatal asphyxia rate.