The Effect of Epidural Analgesia on Maternal and Early Neonatal Outcomes: A Retrospective Cohort Study in Qatar

Author(s): Ismail Sabry Abdelhady, Elsayed Ibrahim Salama*, Sabry Naser Ahmed, Alaa Masry, Ashraf Gad

Objective: Epidural Analgesia (EA) is commonly used method to alleviate labor pain. In the present study, we aimed to describe the maternal and neonatal morbidities associated with EA.

Methods: A retrospective cohort data analysis of the PEARL-Peristat Study. Our sample consisted of a total of 7721 singleton vaginal births occurred at the Woman’s hospital between January 2017 and April 2018. Pregnancy characteristics and maternal and neonatal outcomes were compared between the two groups. Regression analysis was constructed to identify factors associated with the use of EA.

Results: Out of the total participants, 2969 women (38.5%) received epidural analgesia (EA) during labor. Several maternal and pregnancy factors were significantly associated with the use of EA, including Qatari nationality (adjusted odds ratio (aOR) 1.31, 95% confidence interval (CI) 2.10 (1.81-2.44), p<0.001), low parity (aOR 0.79 (0.66-0.96), p=0.017), vaginal birth after Cesarean (aOR 1.92 (1.51-2.45), p<0.001), labor induction (aOR 1.60 (1.39-1.85), p<0.001), prolonged first stage of labor (aOR 1.01 (1.01-1.02), p<0.001), and prolonged second stage of labor (aOR 1.01 (1.01-1.02), p<0.001). Among maternal and neonatal outcome variables, intrapartum fever (aOR 4.43 (1.47-13.38), p=0.008), instrumental delivery (aOR 4.43 (1.47-13.38), p=0.003), and reduced risk of meconium stained amniotic fluid (aOR 0.74 (0.55-0.99), p=0.040) were significantly associated with EA use during labor.

Conclusion: The study identified key factors associated with EA use during labor, including nationality, parity, birth type, labor stages, and specific maternal and neonatal outcomes. Further research is needed to better understand these associations and optimize EA use in labor management.

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