ArticleAJOG global reports2024
Side effects from epidural analgesia in laboring women and risk of cesarean delivery.
Article in AJOG global reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07272018 (Incidence and Clinical Significance of Maternal Hypotension After Labor Epidural Analgesia and Its Effects on Fetal Well-Being), which is not on this map. Cited by 8 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Incidence and Clinical Significance of Maternal Hypotension After Labor Epidural Analgesia and Its Effects on Fetal Well-Being
Who cites it
8 citing papers in PubMed.
- Development and external validation of a LASSO-based nomogram to predict epidural-associated postpartum urinary retention.Journal of anesthesia · 2026Article
- Safety and Efficacy of Dexmedetomidine as an Adjuvant in Epidural Anesthesia for Labor Analgesia: A Narrative Review.Medical sciences (Basel, Switzerland) · 2026Review
- Construction and Validation of a Prediction Model for Conversion to Cesarean Section in Primiparous Women Receiving Epidural Labor Analgesia: A Retrospective Cohort Study.International journal of women's health · 2026Article
- A randomized controlled trial on the effectiveness of peanut ball device during labor on maternal outcomes and stress levels.Journal of education and health promotion · 2026Article
- Feasibility of Hypotension Prediction Index-Guided Monitoring for Epidural Labor Analgesia: A Randomized Controlled Trial.Journal of clinical medicine · 2025Article
- Article
- Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview.Journal of anesthesia, analgesia and critical care · 2025Review
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEpidural analgesia may cause maternal hypotension and changes in the fetal heart rate. The implications of such side effects on the course of labor and delivery are incompletely understood.
objectiveThis study aimed to assess whether the occurrence of maternal or fetal side effects associated with labor epidural analgesia increased the risk for cesarean delivery. STUDY
designThis was a cohort study of all women who underwent epidural analgesia during labor for the period October 1, 2020 to December 31, 2020. Excluded were cases of multiples, fetal death, noncephalic presentation, and gestational age at birth <37.0 weeks. Maternal vital signs and fetal heart rate tracings for the 1 hour before and 1 hour after epidural analgesia was administered were reviewed. The occurrence of maternal hypotension, defined as a continuous variable and dichotomized into a decrease in maternal systolic blood pressure to <90 mm Hg or a drop in systolic blood pressure by >20% below the last value before epidural analgesia was administered, was related to changes in the fetal heart rate category. The principal outcome was cesarean delivery rate; binary logistic regression analysis was used to control for confounders, and mediation model analysis was used to quantify the extent to which significant variables participated in the causation pathway to cesarean delivery (SPSS version 28 was used for the analyses).
resultsA total of 439 women met the study criteria. Significant adverse reactions owing to epidural occurred in 184 of 439 women (41.9%) and included severe maternal hypotension in 159 of 439 participants (36.2%) and worsening fetal heart rate category in 50 of 439 participants (11.4%). The logistic regression analysis revealed that cervical dilation at epidural (
conclusionWorsening fetal heart rate category related to labor epidural independently increased the risk for cesarean delivery.
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