Epidural Analgesia During Labor and Neonatal Hypoxic-Ischemic Encephalopathy
Authors' conclusion
In this cohort study including more than 230 000 parent-infant dyads, epidural analgesia was associated with increased maximal temperature during labor, a known risk factor for HIE. However, epidural analgesia was not associated with increased odds of HIE.
Study context
- Population
- Singleton neonates born at ≥35 weeks' gestation by vaginal or unplanned cesarean delivery after ≥2 hours of in-hospital labor, 15 Kaiser Permanente Northern California hospitals, 2012–2019439 (0.19%) had hypoxic-ischemic encephalopathy (HIE)
- Participants
- 233,056 neonates
- Exposure
- Epidural analgesia during labor vs no epidural analgesia
- Epiduraln = 177,603
- Outcome
- HIE (neonatal acidosis [pH <7 or base deficit ≥10] and encephalopathy)
Methodological detailspopulation-based, multicentre, propensity score adjusted, Data analysis November 2022 to June 2024
- Population-based
- Multicentre
- Propensity score adjusted
- Data analysis November 2022 to June 2024
Main finding
As reported in the abstract
HIE
Epidural vs No epiduralEstimate (95% CI)
Crude
RR 1.21(0.96–1.53)
Adjusted for maximal temperature before epidural and propensity score
aOR 0.93(0.73–1.17)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Maximal temperature >38 °C during laborUnadjusted | RR 8.58 (95% CI 8.06–9.14) | |
| HIE per degree increase in maximal temperature during labor | OR 2.82 (95% CI 2.51–3.17) | |
| 0.10.31310Ratio (log scale) |
Original publication
Epidural Analgesia During Labor and Neonatal Hypoxic-Ischemic Encephalopathy. JAMA Netw Open. Published 3 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →