Association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia: a propensity score-matched single-center retrospective cohort study
Abstract Background Epidural labor analgesia (ELA) is widely and safely used for labor pain relief. However, it remains unclear whether ELA affects maternal and neonatal outcomes in women suffering from preeclampsia. Methods This study reviewed the medical records of women with preeclampsia at ≥ 28 ...
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2025-01-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-025-07155-5 |
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| author | Xi-Zhu Wu Tuan-Fang Fang Yi-Han Zheng Su-Jing Zhang Yi Xie Xiang Gao Guo-Lin Lu |
| author_facet | Xi-Zhu Wu Tuan-Fang Fang Yi-Han Zheng Su-Jing Zhang Yi Xie Xiang Gao Guo-Lin Lu |
| author_sort | Xi-Zhu Wu |
| collection | DOAJ |
| description | Abstract Background Epidural labor analgesia (ELA) is widely and safely used for labor pain relief. However, it remains unclear whether ELA affects maternal and neonatal outcomes in women suffering from preeclampsia. Methods This study reviewed the medical records of women with preeclampsia at ≥ 28 weeks of gestation between January 2015 and December 2020. The medical records of women were divided into ELA and no analgesia (NA) groups. The primary endpoint was the cesarean section (CS) rate. Secondary endpoints included hypotension, operative vaginal delivery, fetal distress, neonatal intensive care unit admission, and complications. Using multivariate logistic regression analysis and propensity score matching (PSM), the association between ELA and maternal and neonatal outcomes was examined. Results A total of medical records of 686 women were enrolled, with 242 (35.3%) receiving ELA. Of these, 126 (18.4%) had a higher incidence of CS in the ELA group than in the NA group (22.7% vs. 16.0%, P = 0.020). Multivariable analysis indicated greater risks of CS [adjusted Odds Ratio (aOR) = 1.71; 95% CI, 1.07–2.74; P = 0.025] and operative vaginal delivery (aOR = 2.810; 95% CI, 1.379–5.725; P = 0.004) in the ELA group than that of NA group. In the PSM, ELA did not increase the risk of CS (aOR = 1.56; 95% CI, 0.97–2.52; P = 0.067) and OVD (aOR = 2.048; 95% CI, 0.936–4.484; P = 0.073). The secondary endpoints showed no significant differences between the two groups. Conclusion The study indicates an association between ELA and maternal and neonatal outcomes, supporting the safety of ELA in this population. |
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| institution | Kabale University |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-b66733a9ab0142b7bc3302c0121b95b92025-01-26T12:57:19ZengBMCBMC Pregnancy and Childbirth1471-23932025-01-0125111010.1186/s12884-025-07155-5Association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia: a propensity score-matched single-center retrospective cohort studyXi-Zhu Wu0Tuan-Fang Fang1Yi-Han Zheng2Su-Jing Zhang3Yi Xie4Xiang Gao5Guo-Lin Lu6Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Medical UniversityDepartment of Anesthesiology, Fujian Children’s Hospital (Fujian Branch of Shanghai Children’s Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Medical UniversityDepartment of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Medical UniversityDepartment of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Medical UniversityCollege of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Department of Obstetrics and Gynecology, Fujian Maternity and Child Health HospitalDepartment of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Medical UniversityDepartment of Anesthesiology, Fujian Children’s Hospital (Fujian Branch of Shanghai Children’s Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Medical UniversityAbstract Background Epidural labor analgesia (ELA) is widely and safely used for labor pain relief. However, it remains unclear whether ELA affects maternal and neonatal outcomes in women suffering from preeclampsia. Methods This study reviewed the medical records of women with preeclampsia at ≥ 28 weeks of gestation between January 2015 and December 2020. The medical records of women were divided into ELA and no analgesia (NA) groups. The primary endpoint was the cesarean section (CS) rate. Secondary endpoints included hypotension, operative vaginal delivery, fetal distress, neonatal intensive care unit admission, and complications. Using multivariate logistic regression analysis and propensity score matching (PSM), the association between ELA and maternal and neonatal outcomes was examined. Results A total of medical records of 686 women were enrolled, with 242 (35.3%) receiving ELA. Of these, 126 (18.4%) had a higher incidence of CS in the ELA group than in the NA group (22.7% vs. 16.0%, P = 0.020). Multivariable analysis indicated greater risks of CS [adjusted Odds Ratio (aOR) = 1.71; 95% CI, 1.07–2.74; P = 0.025] and operative vaginal delivery (aOR = 2.810; 95% CI, 1.379–5.725; P = 0.004) in the ELA group than that of NA group. In the PSM, ELA did not increase the risk of CS (aOR = 1.56; 95% CI, 0.97–2.52; P = 0.067) and OVD (aOR = 2.048; 95% CI, 0.936–4.484; P = 0.073). The secondary endpoints showed no significant differences between the two groups. Conclusion The study indicates an association between ELA and maternal and neonatal outcomes, supporting the safety of ELA in this population.https://doi.org/10.1186/s12884-025-07155-5Epidural labor analgesiaProgrammed intermittent epidural boluspreeclampsiapropensity score-matched analysis |
| spellingShingle | Xi-Zhu Wu Tuan-Fang Fang Yi-Han Zheng Su-Jing Zhang Yi Xie Xiang Gao Guo-Lin Lu Association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia: a propensity score-matched single-center retrospective cohort study BMC Pregnancy and Childbirth Epidural labor analgesia Programmed intermittent epidural bolus preeclampsia propensity score-matched analysis |
| title | Association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia: a propensity score-matched single-center retrospective cohort study |
| title_full | Association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia: a propensity score-matched single-center retrospective cohort study |
| title_fullStr | Association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia: a propensity score-matched single-center retrospective cohort study |
| title_full_unstemmed | Association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia: a propensity score-matched single-center retrospective cohort study |
| title_short | Association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia: a propensity score-matched single-center retrospective cohort study |
| title_sort | association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia a propensity score matched single center retrospective cohort study |
| topic | Epidural labor analgesia Programmed intermittent epidural bolus preeclampsia propensity score-matched analysis |
| url | https://doi.org/10.1186/s12884-025-07155-5 |
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