Perinatal Outcomes and the Role of Obstetric Anesthesia Interventions

(Lancet 2023;401:2038–2039) This editorial discusses multiple recent studies that investigated perinatal outcomes and the impact of anesthetic interventions. A prior study published in the Lancet in 2022 reported poorer perinatal outcomes for neonates born to Black women compared to those born to White women. Another study examined nearly 450,000 deliveries and found an association between neonatal outcomes (Apgar <7 at 5 min, need for neonatal resuscitation, and neonatal admission to the intensive care unit) and maternal use of epidural analgesia. The authors of this editorial examined their own data regarding the incidence of obstetric anesthetic procedures among different ethnic groups and found that compared to White British women who had vaginal birth, incidence of epidural analgesia among Bangladeshi, Pakistani, Black African, and Black Caribbean women was much lower. They noted that similar disparities can be found in the United States and reiterated the socioeconomic and systemic disparities as one likely cause for poor neonatal outcomes, suggesting that offering equal access to neuraxial analgesia across all populations could lead to improved neonatal outcomes for Black women.