Delivery, maternal and neonatal outcomes in nulliparous women with gestational diabetes undergoing epidural labour analgesia: a propensity score-matched analysis
Objective This study aimed to retrospectively analyse the influence of epidural labour analgesia (ELA) on delivery and maternal and neonatal outcomes in nulliparous women with gestational diabetes mellitus (GDM) using propensity score-matched analysis.Design Retrospective cohort analysis.Setting Pri...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-07-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e060245.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832576432008593408 |
|---|---|
| author | Yu Chen Xin Ye Han Wu Yanqing Chen Huanghui Wu Xueling Yuan Xiaofang Yu Xiaodan Wu |
| author_facet | Yu Chen Xin Ye Han Wu Yanqing Chen Huanghui Wu Xueling Yuan Xiaofang Yu Xiaodan Wu |
| author_sort | Yu Chen |
| collection | DOAJ |
| description | Objective This study aimed to retrospectively analyse the influence of epidural labour analgesia (ELA) on delivery and maternal and neonatal outcomes in nulliparous women with gestational diabetes mellitus (GDM) using propensity score-matched analysis.Design Retrospective cohort analysis.Setting Primary care practices in a teaching hospital from March 2018 to October 2021.Participants A total of 816 delivery records of nulliparous women with GDM were collected and retrospectively analysed.Interventions ELA and non-ELA (NELA) cohorts were assessed.Main outcome measure The primary outcome assessed was delivery type (spontaneous, assisted vaginal or caesarean). The secondary outcomes assessed included labour duration and maternal and neonatal outcomes.Results A total of 137 propensity score-matched pairs of ELA and NELA patients were analysed. ELA was associated with a decreased rate of caesarean section (18.3% vs 46.0% in the ELA vs NELA cohort, respectively; p<0.05) and an increased occurrence of assisted vaginal delivery (35.8% vs 12.4% in the ELA vs NELA cohort, respectively; p<0.05). The duration of the first and total stages of labour was prolonged, the occurrence of postpartum fever increased, and the duration of hospital stay was shortened in those receiving ELA (all p<0.05). Additionally, neonatal birth weight, plasma glucose levels and neonatal macrosomia occurrence increased, while neonatal intensive care unit admissions and neonatal hypoglycaemia decreased in the ELA versus the NELA group (all p<0.05). With respect to other maternal and neonatal outcomes, both cohorts were similar.Conclusions The use of ELA decreases the rate of caesarean section and improves maternal and neonatal outcomes in nulliparous women with GDM.Trial registration number ChiCTR-2000033091. |
| format | Article |
| id | doaj-art-b45c89fed0a24a0d8c8d178f2b2f98bf |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-b45c89fed0a24a0d8c8d178f2b2f98bf2025-01-31T06:00:10ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-060245Delivery, maternal and neonatal outcomes in nulliparous women with gestational diabetes undergoing epidural labour analgesia: a propensity score-matched analysisYu Chen0Xin Ye1Han Wu2Yanqing Chen3Huanghui Wu4Xueling Yuan5Xiaofang Yu6Xiaodan Wu7China National Clinical Research Center for Neurological Diseases, Beijing, ChinaInstitute for Global Public Policy, Fudan University, Shanghai, ChinaDepartment of Anaesthesiology, Fujian Provincial Jinshan Hospital, Fuzhou, ChinaDepartment of Anaesthesiology, Fujian Provincial Jinshan Hospital, Fuzhou, ChinaDepartment of Anaesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital Affiliated to Tongji University, Shanghai, ChinaDepartment of Anaesthesiology, Fujian Provincial Jinshan Hospital, Fuzhou, ChinaDepartment of Anaesthesiology, Fujian Provincial Jinshan Hospital, Fuzhou, ChinaDepartment of Anaesthesiology, Fujian Provincial Jinshan Hospital, Fuzhou, ChinaObjective This study aimed to retrospectively analyse the influence of epidural labour analgesia (ELA) on delivery and maternal and neonatal outcomes in nulliparous women with gestational diabetes mellitus (GDM) using propensity score-matched analysis.Design Retrospective cohort analysis.Setting Primary care practices in a teaching hospital from March 2018 to October 2021.Participants A total of 816 delivery records of nulliparous women with GDM were collected and retrospectively analysed.Interventions ELA and non-ELA (NELA) cohorts were assessed.Main outcome measure The primary outcome assessed was delivery type (spontaneous, assisted vaginal or caesarean). The secondary outcomes assessed included labour duration and maternal and neonatal outcomes.Results A total of 137 propensity score-matched pairs of ELA and NELA patients were analysed. ELA was associated with a decreased rate of caesarean section (18.3% vs 46.0% in the ELA vs NELA cohort, respectively; p<0.05) and an increased occurrence of assisted vaginal delivery (35.8% vs 12.4% in the ELA vs NELA cohort, respectively; p<0.05). The duration of the first and total stages of labour was prolonged, the occurrence of postpartum fever increased, and the duration of hospital stay was shortened in those receiving ELA (all p<0.05). Additionally, neonatal birth weight, plasma glucose levels and neonatal macrosomia occurrence increased, while neonatal intensive care unit admissions and neonatal hypoglycaemia decreased in the ELA versus the NELA group (all p<0.05). With respect to other maternal and neonatal outcomes, both cohorts were similar.Conclusions The use of ELA decreases the rate of caesarean section and improves maternal and neonatal outcomes in nulliparous women with GDM.Trial registration number ChiCTR-2000033091.https://bmjopen.bmj.com/content/12/7/e060245.full |
| spellingShingle | Yu Chen Xin Ye Han Wu Yanqing Chen Huanghui Wu Xueling Yuan Xiaofang Yu Xiaodan Wu Delivery, maternal and neonatal outcomes in nulliparous women with gestational diabetes undergoing epidural labour analgesia: a propensity score-matched analysis BMJ Open |
| title | Delivery, maternal and neonatal outcomes in nulliparous women with gestational diabetes undergoing epidural labour analgesia: a propensity score-matched analysis |
| title_full | Delivery, maternal and neonatal outcomes in nulliparous women with gestational diabetes undergoing epidural labour analgesia: a propensity score-matched analysis |
| title_fullStr | Delivery, maternal and neonatal outcomes in nulliparous women with gestational diabetes undergoing epidural labour analgesia: a propensity score-matched analysis |
| title_full_unstemmed | Delivery, maternal and neonatal outcomes in nulliparous women with gestational diabetes undergoing epidural labour analgesia: a propensity score-matched analysis |
| title_short | Delivery, maternal and neonatal outcomes in nulliparous women with gestational diabetes undergoing epidural labour analgesia: a propensity score-matched analysis |
| title_sort | delivery maternal and neonatal outcomes in nulliparous women with gestational diabetes undergoing epidural labour analgesia a propensity score matched analysis |
| url | https://bmjopen.bmj.com/content/12/7/e060245.full |
| work_keys_str_mv | AT yuchen deliverymaternalandneonataloutcomesinnulliparouswomenwithgestationaldiabetesundergoingepidurallabouranalgesiaapropensityscorematchedanalysis AT xinye deliverymaternalandneonataloutcomesinnulliparouswomenwithgestationaldiabetesundergoingepidurallabouranalgesiaapropensityscorematchedanalysis AT hanwu deliverymaternalandneonataloutcomesinnulliparouswomenwithgestationaldiabetesundergoingepidurallabouranalgesiaapropensityscorematchedanalysis AT yanqingchen deliverymaternalandneonataloutcomesinnulliparouswomenwithgestationaldiabetesundergoingepidurallabouranalgesiaapropensityscorematchedanalysis AT huanghuiwu deliverymaternalandneonataloutcomesinnulliparouswomenwithgestationaldiabetesundergoingepidurallabouranalgesiaapropensityscorematchedanalysis AT xuelingyuan deliverymaternalandneonataloutcomesinnulliparouswomenwithgestationaldiabetesundergoingepidurallabouranalgesiaapropensityscorematchedanalysis AT xiaofangyu deliverymaternalandneonataloutcomesinnulliparouswomenwithgestationaldiabetesundergoingepidurallabouranalgesiaapropensityscorematchedanalysis AT xiaodanwu deliverymaternalandneonataloutcomesinnulliparouswomenwithgestationaldiabetesundergoingepidurallabouranalgesiaapropensityscorematchedanalysis |