Epidural Analgesia Linked to Decline in Severe Maternal Morbidity

FRIDAY, May 24, 2024 (HealthDay News) -- Epidural analgesia during labor is associated with a reduction in severe maternal morbidity (SMM), according to a study published online May 22 in The BMJ.

Rachel J. Kearns, M.D., from the Glasgow Royal Infirmary in Scotland, and colleagues conducted a population-based study to examine the effect of labor epidural on SMM in 567,216 women in labor at 24+0 to 42+6 weeks of gestation delivering vaginally or through unplanned cesarean section.

The researchers found that 22.0 percent of women had epidural analgesia during labor. Overall, SMM occurred in 2,412 women (4.3 per 1,000 births). Epidural analgesia was associated with significant decreases in SMM and SMM plus critical care admission (adjusted relative risks, 0.65 and 0.46, respectively) and with a nonsignificant decrease in respiratory morbidity. The risk reduction in SMM was larger for women with a medical indication for epidural analgesia (adjusted relative risk, 0.50). The reduction was more marked for women delivering preterm (adjusted relative risk, 0.53) than those delivering at term or postterm. In the whole cohort and among those with a medical indication for epidural analgesia, the reduced risk in SMM with epidural analgesia was increasingly noticeable as gestational age at birth decreased.

"These findings substantiate the current practice of recommending epidural analgesia during labor to women with known risk factors, underscores the importance of ensuring equitable access to such treatment, and highlights the importance of supporting women from diverse backgrounds to be able to make informed decisions relating to epidural analgesia during labor," the authors write.

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