Are there any strategies to improve neonatal outcomes associated with epidural analgesia in labor?

Are there any strategies to improve neonatal outcomes associated with epidural analgesia in labor?

Authors

  • Marta Armani Università degli studi di Parma
  • Carla Gaggiano Università degli studi di Parma
  • Sara Dallaglio Neonatal Intensive Care Unit, University Hospital, Parma, Italy
  • Enzo Romanini Neonatal Intensive Care Unit, University Hospital, Parma, Italy
  • Carmen Sospiri Department of Obstetrics and Gynecology, University Hospital, Parma, Italy
  • Cinzia Magnani Neonatal Intensive Care Unit, University Hospital, Parma, Italy

Keywords:

Epidural analgesia, labor, newborn, body temperature, breastfeeding, delivery

Abstract

Background and aim of the work: This study was aimed at evaluating the relationship between epidural analgesia and perinatal outcomes and at verifying the advisability of procedural changes in assistance to labor.
Subjects and methods: From January to December 2012, we conducted a retrospective case-control study on 1,963 laboring pregnant women admitted to the Parma University Hospital. We considered two groups: Group 1 received epidural analgesia and Group 2 received no analgesia. Women with elective cesarean sections, multiple pregnancies or deliveries at <34 weeks were excluded. We recorded maternal data (age, type of delivery, obstetric procedures, premature rupture of membranes, screenings for Group-B Streptococcus) and neonatal data (birth weight, gestational age, 1- and 5-minute Apgar scores, diagnosis at discharge).
Results: Of the 1,963 laboring women, 287 requested analgesia and 1,676 did not. We found no significant differences between the two groups in the rates of cesarean section, clavicle fracture, and 1-minute Apgar score between 4 and 7. By contrast, we observed a higher rate of instrumental deliveries (p<0.01), fetal occiput posterior position (p<0.05), neonatal cephalohematoma (p=0.01) in Group 1 than in Group 2 . In Group 1 we also found a higher number of newborns with 1-minute Apgar score of 3 or less (p=0.016). In addition, a significantly higher number of women in Group 1 had fever during labor (p=0.003, odds ratio 5.01).
Conclusions: Our results suggest that strategies should be activated to overcome or limit the side-effects of analgesia in labor through prospective and multidisciplinary studies. 

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Published

01-09-2013

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Section

ORIGINAL ARTICLES

How to Cite

1.
Are there any strategies to improve neonatal outcomes associated with epidural analgesia in labor?. Acta Biomed [Internet]. 2013 Sep. 1 [cited 2024 Apr. 12];84(2):117-23. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/2831

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