Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 31:17:117-127.
doi: 10.2147/LRA.S499370. eCollection 2024.

The Maternal and Neonatal Glycemic Stress Response in Normal Vaginal Delivery: A Comparative Study Between Epidural and Parenteral Opioids Analgesia

Ala A Alhowary  1 , Omar Altal  2 , Diab Bani Hani  1 , Anas Alrusan  1 , Yaser Saleh Ba Jusair  1 , Rania Al-Bataineh  3 , Ahmed Al Sharie  3 , Abdelwahab Aleshawi  3
Affiliations

The Maternal and Neonatal Glycemic Stress Response in Normal Vaginal Delivery: A Comparative Study Between Epidural and Parenteral Opioids Analgesia

Ala A Alhowary et al. Local Reg Anesth. .

Abstract

Background: It has been recognized that the type of anesthetic and analgesic technique and the relative pain degree may have an influence on hyperglycemic-stress response to surgery. This comparative study aimed to assess glucose levels in both mothers and infants during normal vaginal delivery. This study aimed to investigate this stress response between mothers who received parenteral analgesia versus epidural analgesia (EA) as an objective reflection for pain response.

Methods: One hundred and seventeen patients participated in this prospective comparative study. They were categorized into two groups: parenteral analgesia group (who received subcutaneous morphine) and EA group. The primary outcome was to measure the difference in blood glucose level before delivery (at 3 cm cervical dilation), at full dilation, and at the third stage of labor and compare these values between both groups. The secondary outcome was to assess the factors affecting the glycemic stress response in mothers and neonates.

Results: The change in maternal glucose level at full dilation and after delivery were significantly lower in the EA group. Neonatal glucose levels were not significantly different between the two groups. The change in maternal glucose level was influenced by the number of gravity and miscarriages. Neonatal glucose levels were associated with the gestational age of delivery, birth weight, and maternal glucose level at full cervical dilation.

Conclusion: EA appears superior to parenteral opioids analgesia, providing better pain management and subsequent lower stress response levels for mothers during vaginal delivery. These findings highlight the importance of the choice of analgesia during labor to optimize maternal well-being. Optimizing maternal factors (such as glycemic response) and neonatal factors (such as prematurity and birth weight) may influence the stress response of the neonates.

Keywords: epidural; glucose; morphine; normal vaginal delivery.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Similar articles

See all similar articles

References

    1. Lowe NK. The nature of labor pain. Am J Obstet Gynecol. 2002;186(5):S16–S24. doi:10.1067/mob.2002.121427 - DOI - PubMed
    1. Brownridge PJEJOO. Gynecology, and R. Biology. Nat Consequences Childbirth Pain. 1995;59:S9–S15. - PubMed
    1. Boryri T, Noori NM, Teimouri A, et al. The perception of primiparous mothers of comfortable resources in labor pain (a qualitative study). Iran J Nurs Midwifery Res. 2016;21(3):239–246. doi:10.4103/1735-9066.180386 - DOI - PMC - PubMed
    1. Shnol H, Paul N, Belfer IJIAC. Labor pain mechanisms. Int Anesth Clin. 2014;52(3):1–17. doi:10.1097/AIA.0000000000000019 - DOI - PubMed
    1. Taylor CR, Dominguez JE, Habib AS. Obesity and obstetric anesthesia: current insights. Local Reg Anesth. 2019;12:111–124. - PMC - PubMed

LinkOut - more resources