The Effect of Epidural Analgesia on Maternal and Neonatal Birth Outcomes: A Retrospective Analysis of 129 Cases
Öz
Background: The aim of this study was to compare maternal and neonatal birth outcomes in pregnant women who re-ceived epidural anesthesia during labor and those who did not.
Methods: The study included 129 term pregnant women. The women were divided into two groups based on whether they received epidural anesthesia (Epidural group: n=57, Control group: n=72). Demographic characteristics, delivery times, maternal outcomes (mode of delivery, episiotomy, hemoglobin decrease), and neonatal outcomes such as birth weight, APGAR scores, and neonatal intensive care requirements were retrospectively evaluated.
Results: No significant differences were found between the groups in terms of age (24.40±5.09 vs 25.61±5.68, p>0.05) and gestational age (38.65±1.40 vs 38.69±1.47, p>0.05). The second stage of labor was significantly longer in the epidural anesthesia group (38.18±25.50 min vs 24.27±13.50 min, p=0.001). The episiotomy rate was higher in the epidural anes-thesia group (61.4% vs. 51.4%). Birth weight (3230.73±438.89 g vs. 3208.60±384.86 g), 1-minute APGAR score (8.40±0.74 vs 8.43±0.65), and 5-minute APGAR score (9.47±0.66 vs 9.44±0.65). Hemoglobin decrease was similar in both groups (1.44±0.97 g/dL vs 1.41±0.81 g/dL).
Conclusions: Epidural anesthesia prolongs the second stage of labor and was not independently associated with in-creased episiotomy rates. However, it has no adverse effect on neonatal outcomes and is safe in terms of maternal bleed-ing. Epidural anesthesia can be used as an effective and safe option for labor pain management.
Anahtar Kelimeler
Epidural analgesia, Cesarean delivery, Second stage of labor, Labor duration
Destekleyen Kurum
Bu çalışma için herhangi bir finansal destek alınmamıştır.
Etik Beyan
Bu retrospektif kohort çalışması, Helsinki Bildirgesi'ne uygun olarak yürütülmüş ve Gaziantep Şehir Hastanesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (Karar No: 285/2025, Tarih: 17.09.2025). Çalışmanın retrospektif tasarımı nedeniyle, etik kurul tarafından bilgilendirilmiş onam gereksinimi muaf tutulmuştur.
Teşekkür
Yazarlar, veri toplama ve hasta bakımında yardımlarından dolayı Gaziantep Şehir Hastanesi sağlık personeline teşekkür ederler.
Kaynakça
- Callahan EC, Lee W, Aleshi P, George RB. Modern labor epidural analgesia: implications for labor outcomes and maternal-fetal health. Am J Obstet Gynecol. 2023;228(5s):S1260-s9.
- Halliday L, Nelson SM, Kearns RJ. Epidural analgesia in labor: A narrative review. Int J Gynaecol Obstet. 2022;159(2):356-64.
- Hawkins JL. Epidural analgesia for labor and delivery. N Engl J Med. 2010;362(16):1503-10.
- Sultan P, Murphy C, Halpern S, Carvalho B. The effect of low concentrations versus high concentrations of local anesthetics for labour analgesia on obstetric and anesthetic outcomes: a meta-analysis. Can J Anaesth. 2013;60(9):840-54.
- Xu J, Zhou J, Xiao H, Pan S, Liu J, Shang Y, et al. A Systematic Review and Meta-Analysis Comparing Programmed Intermittent Bolus and Continuous Infusion as the Background Infusion for Parturient-Controlled Epidural Analgesia. Sci Rep. 2019;9(1):2583.
- Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018;5(5):Cd000331.
- Kearns RJ, Kyzayeva A, Halliday LOE, Lawlor DA, Shaw M, Nelson SM. Epidural analgesia during labour and severe maternal morbidity: population based study. Bmj. 2024;385:e077190.
- Reynolds F. Labour analgesia and the baby: good news is no news. Int J Obstet Anesth. 2011;20(1):38-50.
- Zanfini BA, Catarci S, Vassalli F, Laurita Longo V, Biancone M, Carducci B, et al. 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. Journal of Clinical Medicine. 2022;11(20):6124.
- ACOG Committee Opinion No. 766: Approaches to Limit Intervention During Labor and Birth. Obstet Gynecol. 2019;133(2):e164-e73.