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)
Year published
2020
Metadata
Show full item recordAbstract
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 ...
View more >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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View more >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.
View less >
Journal Title
Women and Birth
Note
This publication has been entered in Griffith Research Online as an advanced online version.
Subject
Paediatrics and Reproductive Medicine
Medical and Health Sciences