Obstetric analgesia in labor and its association with neonatal outcomes

Rev Bras Enferm. 2020 Jul 1;73(5):e20180757. doi: 10.1590/0034-7167-2018-0757. eCollection 2020.
[Article in English, Portuguese]

Abstract

Objetive: To investigate the association between analgesia during labor and occurrence of neonatal outcomes.

Method: Retrospective cohort study with medical records of 850 parturient. The exposure variable of interest was receiving pharmacological analgesia during labor and neonatal outcomes were: one- and five-minute Apgar, resuscitation maneuvers and referral of the newborn to Neonatal ICU. A logistic regression was carried out to obtain Odds Ratios and 95% confidence interval, with adjustment for confounding factors.

Results: Among the women studied, 35% received analgesia and this use was associated with a greater chance of neonatal outcomes such as one-minute Apgar < 7 (p <0.0001), resuscitation maneuvers (p <0.001) and referral to the Neonatal ICU (p = 0.004), mostly were among low-risk pregnant women, even after adjustments.

Conclusion: The use of pharmacological analgesia during labor is associated with one-minute Apgar < 7, resuscitation maneuvers and referral to the Neonatal ICU.

MeSH terms

  • Adolescent
  • Adult
  • Analgesia, Obstetrical / adverse effects*
  • Analgesia, Obstetrical / methods
  • Analgesia, Obstetrical / statistics & numerical data*
  • Apgar Score
  • Brazil / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Infant, Newborn
  • Labor, Obstetric / drug effects*
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Outcome / epidemiology
  • Retrospective Studies
  • Risk Factors