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The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson’s Classes: A Propensity Score-Matched Analysis
Background: Lumbar epidural analgesia (EA) is the most commonly used method for reducing labour pain, but its impact on the duration of the second stage of labour and on neonatal and maternal outcomes remains a matter of debate. Our aim was to examine whether EA affected the course and the outcomes...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604843/ https://www.ncbi.nlm.nih.gov/pubmed/36294447 http://dx.doi.org/10.3390/jcm11206124 |
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author | Zanfini, Bruno Antonio Catarci, Stefano Vassalli, Francesco Laurita Longo, Valentina Biancone, Matteo Carducci, Brigida Frassanito, Luciano Lanzone, Antonio Draisci, Gaetano |
author_facet | Zanfini, Bruno Antonio Catarci, Stefano Vassalli, Francesco Laurita Longo, Valentina Biancone, Matteo Carducci, Brigida Frassanito, Luciano Lanzone, Antonio Draisci, Gaetano |
author_sort | Zanfini, Bruno Antonio |
collection | PubMed |
description | Background: Lumbar epidural analgesia (EA) is the most commonly used method for reducing labour pain, but its impact on the duration of the second stage of labour and on neonatal and maternal outcomes remains a matter of debate. Our aim was to examine whether EA affected the course and the outcomes of labour among patients divided according to the Robson-10 group classification system. Methods: Patients of Robson’s classes 1, 2a, 3, and 4a were divided into either the EA group or the non-epidural analgesia (NEA) group. A propensity score-matching analysis was performed to balance the intergroup differences. The primary goal was to analyse the duration of the second stage of labour. The secondary goals were to evaluate neonatal and maternal outcomes. Results: In total, 21,808 cases were analysed. The second stage of labour for all groups was prolonged using EA (p < 0.05) without statistically significant differences in neonatal outcomes. EA resulted in a lower rate of episiotomies in nulliparous patients, with a higher rate of operative vaginal deliveries (OVD) (p < 0.05) and Caesarean sections (CS) (p < 0.05) in some classes. Conclusions: EA prolonged the duration of labour without affecting neonatal outcomes and reduced the rate of episiotomies, but also increased the rate of OVDs. |
format | Online Article Text |
id | pubmed-9604843 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96048432022-10-27 The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson’s Classes: A Propensity Score-Matched Analysis Zanfini, Bruno Antonio Catarci, Stefano Vassalli, Francesco Laurita Longo, Valentina Biancone, Matteo Carducci, Brigida Frassanito, Luciano Lanzone, Antonio Draisci, Gaetano J Clin Med Article Background: Lumbar epidural analgesia (EA) is the most commonly used method for reducing labour pain, but its impact on the duration of the second stage of labour and on neonatal and maternal outcomes remains a matter of debate. Our aim was to examine whether EA affected the course and the outcomes of labour among patients divided according to the Robson-10 group classification system. Methods: Patients of Robson’s classes 1, 2a, 3, and 4a were divided into either the EA group or the non-epidural analgesia (NEA) group. A propensity score-matching analysis was performed to balance the intergroup differences. The primary goal was to analyse the duration of the second stage of labour. The secondary goals were to evaluate neonatal and maternal outcomes. Results: In total, 21,808 cases were analysed. The second stage of labour for all groups was prolonged using EA (p < 0.05) without statistically significant differences in neonatal outcomes. EA resulted in a lower rate of episiotomies in nulliparous patients, with a higher rate of operative vaginal deliveries (OVD) (p < 0.05) and Caesarean sections (CS) (p < 0.05) in some classes. Conclusions: EA prolonged the duration of labour without affecting neonatal outcomes and reduced the rate of episiotomies, but also increased the rate of OVDs. MDPI 2022-10-18 /pmc/articles/PMC9604843/ /pubmed/36294447 http://dx.doi.org/10.3390/jcm11206124 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Zanfini, Bruno Antonio Catarci, Stefano Vassalli, Francesco Laurita Longo, Valentina Biancone, Matteo Carducci, Brigida Frassanito, Luciano Lanzone, Antonio Draisci, Gaetano The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson’s Classes: A Propensity Score-Matched Analysis |
title | The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson’s Classes: A Propensity Score-Matched Analysis |
title_full | The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson’s Classes: A Propensity Score-Matched Analysis |
title_fullStr | The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson’s Classes: A Propensity Score-Matched Analysis |
title_full_unstemmed | The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson’s Classes: A Propensity Score-Matched Analysis |
title_short | The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson’s Classes: A Propensity Score-Matched Analysis |
title_sort | effect of epidural analgesia on labour and neonatal and maternal outcomes in 1, 2a, 3, and 4a robson’s classes: a propensity score-matched analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604843/ https://www.ncbi.nlm.nih.gov/pubmed/36294447 http://dx.doi.org/10.3390/jcm11206124 |
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