The effect of epidural analgesia on the clinical maternal and neonatal outcomes in parturients: a prospective cohort study

Epidural analgesia seems to be one of the most effective methods of controlling labor pain. However, no comprehensive agreement has been reached regarding its side effects. Therefore, the following study was designed to investigate the clinical maternal and neonatal outcomes.

In a prospective cohort study, from November 2020 to October 2022, 600 primigravid patients were included in two equal epidural analgesia and control groups. The uterine atony, grade 3-4 perineal injury rate, fetal head descent, shoulder dystocia, duration of neonatal hospitalization, cesarean delivery, fever and headache, oxytocin administration, successful breastfeeding, instrumented vaginal delivery, the first-minute Apgar Score were compared between the two groups. The data were analyzed by SPSS-26 with the Chi-square test and T-test.

The duration of the active phase, uterine atony, grade 3-4 perineal injury rate and fetal head descent, shoulder dystocia, duration of neonatal hospitalization, and successful breastfeeding between the two groups were not statistically significant(P-value>0.05). Importantly, the incidence of cesarean delivery, fever, headache, and oxytocin administration was significantly higher in the epidural group (P-value <0.05). Regarding the comparison of neonatal outcomes, the use of instrumented vaginal delivery, the first-minute Apgar Score, and the frequency of hospitalization between the two groups were found to be significantly different (P-value 0.03, 0.02, 0.007 respectively).

Although the probability of emergency cesarean delivery following epidural labor analgesia increases and the first-minute Apgar score decreases, the serious side effects of epidural labor analgesia seem to be few and its use is effective and safe in reducing labor pain.