Epidural Analgesia and Neonatal Morbidity: A Retrospective Cohort Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Design and Participants
2.2. Sources of Information
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variables | Epidural Analgesia | p-Value | |
---|---|---|---|
No (n = 503) | Yes (n = 2441) | ||
Maternal Age | 0.665 | ||
Mean (SD) | 30.8 (5.67) | 30.7 (5.20) | |
Gestational Age | <0.001 | ||
Mean (SD) | 39.5 (1.07) | 39.8 (1.06) | |
Parity | <0.001 | ||
Nulliparous | 112 (22.3) | 1348 (55.2) | |
Multiparous | 391 (77.7) | 1093 (44.8) | |
Previous CS | 0.137 | ||
No | 478 (95.0) | 2276 (93.2) | |
Yes | 25 (5.0) | 165 (6.8) | |
BMI | |||
Mean (SD) | 24.7 (4.60) | 24.4 (4.54) | 0.579 |
Newborn weight (grams) | 0.051 | ||
Mean (SD) | 3271.8 (444.82) | 3313.8 (412.01) | |
First stage of labor duration (minutes) | <0.001 | ||
Mean (SD) | 94.4 (97.19) | 270.5 (161.56) | |
Second stage of labor duration (minutes) | <0.001 | ||
Mean (SD) | 19.3 (23.12) | 78.4 (63.37) | |
Type of delivery | <0.001 | ||
Normal Vaginal | 503 (100.0) | 2006 (82.2) | |
Instrumental | 0 (0.0) | 194 (7.9) | |
Emergency CS | 0 (0.0) | 241 (9.9) |
Variables | Epidural Analgesia | p- Value Aj * | |||
---|---|---|---|---|---|
No (n = 503) n (%) | Yes (n = 2441) n (%) | OR Crude | OR Adjusted * | ||
Umbilical artery pH | 0.831 | ||||
≥7.10 (Ref) | 425 (98.6) | 2164 (98.2) | 1.00 | 1.00 | |
<7.10 | 6 (1.4) | 39 (1.8) | 1.27 [0.54, 2.99] | 0.78 [0.31, 1.96] | |
Missing | 72 | 238 | |||
Apgar at 5 min | 0.993 | ||||
≥7 (Ref) | 503 (100.0) | 2430 (99.6) | 1.00 | 1.00 | |
<7 | 0 (0.0) | 10 (0.4) | NC | NC | |
Missing | 0 | 0 | |||
Degree of neonatal resuscitation | 0.992 | ||||
Basic (Ref) | 503 (100.0) | 2330 (97.1) | 1.00 | 1.00 | |
Advanced | 0 (0.0) | 71 (2.9) | NC | NC | |
Missing | 0 | 0 | |||
Composite morbidity | 0.132 | ||||
No (Ref) | 497 (98.8) | 2338 (95.8) | 1.00 | 1.00 | |
Yes | 6 (1.2) | 103 (4.2) | 3.65 [1.59, 8.36] | 1.97 [0.82, 4.74] | |
Missing | 0 | 0 |
Variables | Second Stage of Labor Duration | p-Value | |||
---|---|---|---|---|---|
<1 h (n = 1577) n (%) | 1–2 h (n = 547) n (%) | 2–3 h (n = 357) n (%) | ≥3 h (269)n (%) | ||
No EA | NC * | ||||
Normal Vaginal | 476 (94.8) | 18 (3.6) | 6 (1.2) | 2 (0.4) | |
Instrumental | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
C-section | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Use of EA | <0.001 | ||||
Normal Vaginal | 1049 (52.4) | 495 (24.7) | 281 (14.0) | 177 (8.8) | |
Instrumental | 46 (23.7) | 27 (13.9) | 54 (27.8) | 67 (34.5) | |
CS | 6 (11.5) | 7 (13.5) | 16 (30.8) | 23 (44.2) |
Umbilical Artery pH < 7.10 | Aj. OR * | CI 95% | p-Value |
---|---|---|---|
Use of EA | 0.89 | 0.33, 2.37 | 0.813 |
Type of delivery (Ref. Normal Vaginal) | |||
Instrumental delivery | 2.68 | 1.15, 6.27 | 0.023 |
C-section | 2.32 | 0.50, 10.73 | 0.282 |
Second stage of labor duration (Ref. < 1 h) | |||
1–2 h | 0.74 | 0.31, 1.78 | 0.497 |
2–3 h | 0.83 | 0.32, 2.16 | 0.702 |
>3 h | 0.81 | 0.48, 2.34 | 0.699 |
Apgar at 5 min < 7 | Aj. OR * | CI 95% | p-Value |
Use of EA | NC | NC | 0.933 |
Type of delivery (Ref. Normal Vaginal) | |||
Instrumental delivery | 4.11 | 0.59, 28.70 | 0.154 |
C-section | 8.23 | 0.68, 100.45 | 0.999 |
Second stage of labor duration (Ref. < 1 h) | |||
1–2 h | NC | NC | 0.992 |
2–3 h | 0.61 | 0.09, 4.09 | 0.607 |
>3 h | 0.28 | 0.02, 3.28 | 0.311 |
Advanced neonatal resuscitation | Aj. OR * | CI 95% | p-Value |
Use of EA | NC | NC | 0.993 |
Type of delivery (Ref. Normal Vaginal) | |||
Instrumental delivery | 2.44 | 1.17, 5.08 | 0.017 |
C-section | 2.56 | 0.71, 9.24 | 0.151 |
Second stage of labor duration (Ref. < 1 h) | |||
1–2 h | 0.90 | 0.46, 1.78 | 0.766 |
2–3 h | 0.66 | 0.29, 1.50 | 0.321 |
>3 h | 0.38 | 0.13-1.10 | 0.075 |
Composite morbidity | Aj. OR * | CI 95% | p-Value |
Use of EA | 1.80 | 0.75, 4.37 | 0.191 |
Type of delivery (Ref. Normal Vaginal) | |||
Instrumental delivery | 2.86 | 1.59, 5.12 | <0.001 |
C-section | 2.20 | 0.73, 6.65 | 0.161 |
Second stage of labor duration (Ref. < 1 h) | |||
1–2 h | 0.85 | 0.49, 1.50 | 0.580 |
2–3 h | 0.73 | 0.38, 1.40 | 0.340 |
>3 h | 0.52 | 0.24, 1.14 | 0.112 |
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Martínez, A.H.; Almagro, J.J.R.; García-Suelto, M.M.-C.; Barrajon, M.U.; Alarcón, M.M.; Gómez-Salgado, J. Epidural Analgesia and Neonatal Morbidity: A Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2018, 15, 2092. https://doi.org/10.3390/ijerph15102092
Martínez AH, Almagro JJR, García-Suelto MM-C, Barrajon MU, Alarcón MM, Gómez-Salgado J. Epidural Analgesia and Neonatal Morbidity: A Retrospective Cohort Study. International Journal of Environmental Research and Public Health. 2018; 15(10):2092. https://doi.org/10.3390/ijerph15102092
Chicago/Turabian StyleMartínez, Antonio Hernández, Julián Javier Rodríguez Almagro, María Moreno-Cid García-Suelto, María Ureña Barrajon, Milagros Molina Alarcón, and Juan Gómez-Salgado. 2018. "Epidural Analgesia and Neonatal Morbidity: A Retrospective Cohort Study" International Journal of Environmental Research and Public Health 15, no. 10: 2092. https://doi.org/10.3390/ijerph15102092
APA StyleMartínez, A. H., Almagro, J. J. R., García-Suelto, M. M.-C., Barrajon, M. U., Alarcón, M. M., & Gómez-Salgado, J. (2018). Epidural Analgesia and Neonatal Morbidity: A Retrospective Cohort Study. International Journal of Environmental Research and Public Health, 15(10), 2092. https://doi.org/10.3390/ijerph15102092