Perinatal outcomes after regional analgesia during labour

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology Pub Date : 2024-02-13 DOI:10.1111/ajo.13797

Janna Lawson, Lahiru Amaratunge, Melody Goh, Roshan J. Selvaratnam

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引用次数: 0

Abstract

Background

Regional analgesia is a common and effective form of in-labour analgesia. However, there are concerns whether it is associated with adverse maternal and neonatal outcomes.

Aims

To examine the association between regional analgesia and maternal and neonatal outcomes.

Materials and Methods

A retrospective population-based cohort study of singleton term births in Victoria, Australia, between 2014 and 2020. Women who received regional analgesia were compared with women who did not. Multivariable logistic and linear regressions were used.

Results

There were 107 013 women who received regional analgesia and 214 416 women who did not. Compared to women who did not receive regional analgesia, regional analgesia was associated with an increased risk of instrumental birth (adjusted odds ratio (aOR) = 3.59, 95% CI: 3.52–3.67), caesarean section (aOR = 2.30, 95% CI: 2.24–2.35), longer duration of the second stage of labour (β coefficient = 26.6 min, 95% CI: 26.3–27.0), Apgar score below seven at five minutes (aOR = 1.30, 95% CI: 1.21–1.39), need for neonatal resuscitation (aOR = 1.44, 95% CI: 1.40–1.48), need for formula in hospital (aOR = 1.68, 95% CI: 1.65–1.72), and the last feed before discharge not exclusively from the breast (aOR = 1.59, 95% CI: 1.56–1.62).

Conclusion

Regional analgesia use in labour was associated with adverse maternal and neonatal outcomes. These findings may add to the risk–benefit discussion regarding regional analgesia for pain relief and highlight the importance of shared decision-making. Further large prospective studies and randomised controlled trials will be useful.

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分娩区域镇痛后的围产期结果。

背景：区域镇痛是一种常见且有效的分娩镇痛方式。目的：研究区域镇痛与产妇和新生儿结局之间的关系：对 2014 年至 2020 年期间在澳大利亚维多利亚州出生的单胎足月新生儿进行基于人群的回顾性队列研究。接受区域镇痛的产妇与未接受区域镇痛的产妇进行了比较。采用多变量逻辑回归和线性回归：结果：接受区域镇痛的产妇有 107 013 人，未接受区域镇痛的产妇有 214 416 人。与未接受区域镇痛的产妇相比，区域镇痛与器械助产（调整后的几率比（aOR）= 3.59，95% CI：3.52-3.67）、剖腹产（aOR = 2.30，95% CI：2.24-2.35）、第二产程持续时间延长（β系数 = 26.6 分钟，95% CI：26.3-27.0）、5 分钟时 Apgar 评分低于 7 分（aOR = 1.30，95% CI：1.21-1.39）、新生儿复苏需求（aOR = 1.44，95% CI：1.40-1.48）、住院期间配方奶需求（aOR = 1.68，95% CI：1.65-1.72）、出院前最后一次喂养不完全是母乳（aOR = 1.59，95% CI：1.56-1.62）：结论：分娩时使用区域镇痛与产妇和新生儿的不良结局有关。这些研究结果可能会增加有关区域镇痛的风险-收益讨论，并强调共同决策的重要性。进一步的大型前瞻性研究和随机对照试验将非常有用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian & New Zealand Journal of Obstetrics & Gynaecology 医学-妇产科学

CiteScore

3.40

自引率

11.80%

发文量

165

审稿时长

4-8 weeks

期刊介绍： The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.