Epidural Analgesia and Neonatal Morbidity: A Retrospective Cohort Study

Antonio Hernández Martínez, Julián Javier Rodríguez Almagro, María Moreno-Cid García-Suelto, María Ureña Barrajon, Milagros Molina Alarcón and Juan Gómez-Salgado
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Antonio Hernández Martínez: Midwife Unit, Mancha-Centro Hospital, 13600 Alcázar de San Juan, Ciudad Real, Spain
Julián Javier Rodríguez Almagro: Department of Emergency, Ciudad Real University Hospital, 13005 Ciudad Real, Ciudad Real, Spain
María Moreno-Cid García-Suelto: Midwife Unit, Mancha-Centro Hospital, 13600 Alcázar de San Juan, Ciudad Real, Spain
María Ureña Barrajon: Midwife Unit, Mancha-Centro Hospital, 13600 Alcázar de San Juan, Ciudad Real, Spain
Milagros Molina Alarcón: Department of Nursing, Faculty of Nursing, University of Castilla la Mancha, 02071 Albacete, Spain
Juan Gómez-Salgado: Department of Nursing, Faculty of Nursing, University of Huelva, 21071 Huelva, Spain

IJERPH, 2018, vol. 15, issue 10, 1-10

Abstract: (1) Background : Epidural analgesia (EA), at the present time, is one of the most effective methods to reduce labor pain. In recent years its use has increased, being used between 20–70% of all deliveries; (2) Methods : Historical cohort on a total of 2947 deliveries during the years 2012–2016 at the “Mancha-Centro Hospital” of Alcázar de San Juan. The main outcome variables were four neonatal morbidity (NM) criteria: umbilical artery pH of <7.10, Apgar score at 5 min < 7, need for advanced resuscitation and composite morbidity. We used the multivariate analysis to control confounding bias. (3) Results : No statistical relationship between EA and the second stage of labor duration with none of the four criteria of NM used ( p > 0.005). However, the type of delivery was associated with three criteria (pH, resuscitation, and composite morbidity). The instrumental delivery presented an OR of pH < 7.10 of 2.68 95% CI [1.15, 6.27], an OR of advanced resuscitation of 2.44 95% CI [1.17, 5.08] and OR of composite morbidity of 2.86 95% CI [1.59, 5.12]; (4) Conclusions : The EA and the second stage of labor duration are not related to the NM. While the instrumental delivery doubles the risk of NM compared to the normal vaginal delivery.

Keywords: Apgar; epidural analgesia; neonatal morbidity; neonatal resuscitation; umbilical artery pH (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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