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  • Comparison of labour and birth outcomes between nulliparous women who used epidural analgesia in labour and those who did not: A prospective cohort study

    Author(s)
    Newnham, Elizabeth C
    Moran, Patrick S
    Begley, Cecily M
    Carroll, Margaret
    Daly, Deirdre
    Griffith University Author(s)
    Newnham, Elizabeth C.
    Year published
    2020
    Metadata
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    Abstract
    Objective: To compare labour and birth outcomes between nulliparous women who used versus did not use intrapartum epidural analgesia. Design: Prospective cohort study. Setting: Two maternity hospitals in Ireland. Population: A total of 1221 nulliparous women who gave birth vaginally or by emergency caesarean section. Methods: Multinomial logistic regression was used to analyse categorical outcomes, with results presented as ratios of relative risks (RRR). For dichotomous outcomes we used logistic regression, with results presented as odds ratios (OR). Main outcome measures: Mode of birth, IV syntocinon use, pyrexia (≥38 ...
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    Objective: To compare labour and birth outcomes between nulliparous women who used versus did not use intrapartum epidural analgesia. Design: Prospective cohort study. Setting: Two maternity hospitals in Ireland. Population: A total of 1221 nulliparous women who gave birth vaginally or by emergency caesarean section. Methods: Multinomial logistic regression was used to analyse categorical outcomes, with results presented as ratios of relative risks (RRR). For dichotomous outcomes we used logistic regression, with results presented as odds ratios (OR). Main outcome measures: Mode of birth, IV syntocinon use, pyrexia (≥38 °C), antibiotic treatment, first stage labour ≥10 h, second stage labour ≥2 h, blood loss (≥500 mls, ≥1000 mls), perineal trauma. Neonatal outcomes included APGAR score ≥7 at 1 min and 5 min, admission to neonatal intensive care unit, and infant feeding method. Results: Women using EA were more likely to require a vacuum-assisted birth (RRR 3.35, p < 0.01) or forceps-assisted birth (RRR 11.69, p < 0.01). Exposure to EA was associated with significantly greater risk of ≥10 h first (OR 6.72, p = 0.01) and ≥2 h second (OR 2.25, p < 0.01) stage labour, increased likelihood of receiving IV syntocinon (OR 9.38, p < 0.01), antibiotics (OR 2.97, p < 0.01) and a greater probability of pyrexia (OR 10.26, p < 0.01). Women who used EA were half as likely to be breastfeeding at three months postpartum (OR 0.53, p < 0.01). No differences were observed between groups in neonatal outcomes. Conclusions: Our data shows significant associations between EA use and several intrapartum outcomes.
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    Journal Title
    Women and Birth
    DOI
    https://doi.org/10.1016/j.wombi.2020.09.001
    Note
    This publication has been entered in Griffith Research Online as an advanced online version.
    Subject
    Paediatrics and Reproductive Medicine
    Medical and Health Sciences
    Publication URI
    http://hdl.handle.net/10072/397782
    Collection
    • Journal articles

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