Evidence map›Paper›PMID 34187400›Full record

Observational studyBMC pregnancy and childbirth2021

Association between epidural analgesia and indications for intrapartum caesarean delivery in group 1 of the 10-group classification system at a tertiary maternity hospital, Shanghai, China: a retrospective cohort study.

Rong Lin, Peng Shi, Haibing Li, Zhiqiang Liu, Zhendong Xu

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Rong LinDepartment of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No. 2699 W Gaoke Rd, Shanghai, 201024, China.
Peng ShiDepartment of Statistics and Data Management, Children's Hospital of Fudan University, No. 399 Wanyuan Rd, Shanghai, 201102, China.
Haibing LiDepartment of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No. 2699 W Gaoke Rd, Shanghai, 201024, China.
Zhiqiang LiuDepartment of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No. 2699 W Gaoke Rd, Shanghai, 201024, China. drliuzhiqiang@163.com.
Zhendong XuDepartment of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No. 2699 W Gaoke Rd, Shanghai, 201024, China. btxzd123@126.com.ORCID http://orcid.org/0000-0002-2696-3492

Funding

Shanghai Municipal Health Bureau 201840149
6 · The paper itself

Abstract

backgroundIn this study, we aimed to determine whether epidural analgesia affects the indications for intrapartum caesarean delivery, such as foetal distress, dystocia, or maternal request, in nulliparous term women with spontaneous labour (Group 1 in the 10-Group Classification System).

methodsWe conducted a retrospective cohort study and collected data from the electronic medical records of deliveries performed in our institution between 1 January 2017 and 30 June 2017. Women conforming to the criterion of Group 1 according to the 10-Group Classification System were enrolled. We compared labour outcomes between women with and without epidural analgesia and analysed the association between epidural analgesia and indications for caesarean by using multivariate logistic regression analysis.

resultsA total of 3212 women met the inclusion criteria, and 2876 were enrolled in the final analyses. Women who received epidural analgesia had a significantly lower intrapartum caesarean delivery rate (16.0% vs. 26.7%, P < 0.001), higher rates of amniotomy (53.4% vs. 42.3%, P < 0.001) and oxytocin augmentation (79.5% vs. 67.0%, P < 0.001), and a higher incidence of intrapartum fever (≥38 °C) (23.3% vs. 8.5%, P < 0.001) than those who did not receive epidural analgesia. There were no significant differences between the groups for most indications, except a lower probability of maternal request for caesarean delivery (3.9% vs. 10.5%, P < 0.001) observed in women who received epidural analgesia than in those who did not. Epidural analgesia was revealed to be associated with a decreased risk of maternal request for caesarean delivery (adjusted odds ratio [aOR], 0.30; 95% confidence interval [CI], 0.22-0.42; P < 0.001); however, oxytocin augmentation was related to an increased risk of maternal request (aOR, 2.34; 95%CI, 1.47-3.75; P < 0.001). Regarding the reasons for the maternal request for caesarean delivery, significantly fewer women complained of pain (0.5% vs. 4.6%, P < 0.001) or had no labour progress (1.3% vs. 3.6%, P < 0.001) among those who received analgesia.

conclusionsAmong the women in Group 1, epidural analgesia was associated with a lower intrapartum caesarean delivery rate, which may be explained by a reduction in the risk of maternal request for an intrapartum caesarean delivery.

Indexed as

AdultAnalgesia, EpiduralCesarean SectionChinaCohort StudiesFemaleHospitals, MaternityHumansPregnancyRetrospective StudiesTertiary Care CentersCaesarean deliveryEpidural anaesthesiaIntrapartumLabour painNulliparous women

Identifiers

PMID34187400
PMCPMC8243735

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.