Labor analgesia and its impact on the maternal and perinatal outcomes.

Abstract

Objective: This study aimed to assess adverse maternal and perinatal outcomes in parturients undergoing labor analgesia.

Methods: This was a retrospective cohort study in parturients who underwent labor analgesia. Parturients were categorized into three groups: Group 1 (n=83)-analgesia performed with cervical dilatation ≤4.0 cm; Group 2 (n=82)-analgesia performed with cervical dilatation between 5.0 and 8.0 cm; and Group 3 (n=83)-analgesia performed with cervical dilatation ≥9.0 cm.

Results: Analgesia in parturients with cervical dilatation ≥9.0 cm showed a higher prevalence and a 3.86-fold increase (OR 3.86; 95%CI 1.50-9.87; p=0.009) in the risk of forceps delivery. Analgesia in parturients with cervical dilatation ≤4.0 cm showed a higher prevalence and a 3.31-fold increase (OR 3.31; 95%CI 1.62-6.77; p=0.0016) in the risk of cesarean section. Analgesia in parturients with cervical dilatation ≥9.0 cm was associated with a higher prevalence of fetal bradycardia (20.7%), a need for neonatal oxygen therapy (6.1%), and a need for admission to a neonatal intensive care unit (4.9%). Analgesia in parturients with cervical dilatation ≤4 cm was associated with a higher prevalence of Apgar score <7 at 1st minute (44.6%).

Conclusion: Performing labor analgesia in parturients with cervical dilatation ≤4.0 or ≥9.0 cm was associated with a higher prevalence of adverse maternal and perinatal outcomes.