Epidural analgesia in labour is not associated with adverse neonatal health outcomes

1. Epidural analgesia in labour is not associated with significant risk of neonatal neurological morbidity, neonatal morbidity or mortality. 

Evidence Rating Level: 2 (Good)

Epidural analgesia during labour is regarded as the most effective form of pain control, which is important given that poor pain control may lead to physiological stress in mothers with important consequences on the fetus. However, epidural analgesia is also associated with adverse effects such as maternal hypotension and fetal heart rate abnormalities. This population-based cohort study therefore sought to investigate the association between epidural analgesia in labour and neonatal health outcomes including neonatal neurological morbidity, neonatal morbidity and neonatal mortality. 495,695 women in labour in Scotland between January 2007 and December 2019 were included in this study. Of these women, 114,897 (23.2%) received epidural analgesia. There was no association between epidural analgesia in labour and risk of neonatal neurological morbidity (adjusted relative risk, 0.87 [95% CI: 0.68-1.12]), other neonatal morbidity (adjusted relative risk, 1.17 [95% CI: 0.90-1.51]) or mortality at 28 days (adjusted relative risk, 0.81 [95% CI: 0.62-1.06]). Overall, this study found that the use of epidural analgesia in labour was not associated with significant risk of adverse neonatal health outcomes including neurological morbidity, other causes of morbidity or mortality.  

Click here to read the study in BMJ

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