Wu Xi-Zhu, Fang Tuan-Fang, Zheng Yi-Han, Zhang Su-Jing, Xie Yi, Gao Xiang, Lu Guo-Lin
Department 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 University, Fujian, Fuzhou 350001, China.
Department 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 University, Fujian, Fuzhou 350001, China.
BMC Pregnancy Childbirth. 2025 Jan 24;25(1):66. doi: 10.1186/s12884-025-07155-5.
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.
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.
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.
The study indicates an association between ELA and maternal and neonatal outcomes, supporting the safety of ELA in this population.
硬膜外分娩镇痛（ELA）被广泛且安全地用于缓解分娩疼痛。然而，ELA是否会影响子痫前期女性的母婴结局仍不清楚。
本研究回顾了2015年1月至2020年12月期间妊娠≥28周的子痫前期女性的病历。将这些女性的病历分为ELA组和无镇痛（NA）组。主要终点是剖宫产（CS）率。次要终点包括低血压、阴道助产、胎儿窘迫、新生儿重症监护病房入院和并发症。使用多因素逻辑回归分析和倾向得分匹配（PSM）来检验ELA与母婴结局之间的关联。
共纳入686名女性的病历，其中242名（35.3%）接受了ELA。其中，126名（18.4%）的ELA组CS发生率高于NA组（22.7%对16.0%，P = 0.020）。多变量分析表明，ELA组CS [调整优势比（aOR）= 1.71；95%置信区间，1.07 - 2.74；P = 0.025] 和阴道助产（aOR = 2.810；95%置信区间，1.379 - 5.725；P = 0.004）的风险高于NA组。在PSM中，ELA并未增加CS（aOR = 1.56；95%置信区间，0.97 - 2.52；P = 0.067）和阴道助产（aOR = 2.048；95%置信区间，0.936 - 4.484；P = 0.073）的风险。次要终点在两组之间无显著差异。
该研究表明ELA与母婴结局之间存在关联，支持ELA在该人群中的安全性。
