title: The need for epidural analgesia is related to birthweight - a population-based register study.
abstract: OBJECTIVE
  To investigate the relation between use of epidural analgesia (EDA) and maternal and fetal characteristics.
  
  
  METHODS
  Population-based register study.
  
  
  METHODS
  Nationwide study in Sweden.
  
  
  METHODS
  All 106,775 primiparous women who in 2002-2005 delivered a singleton infant vaginally at term.
  
  
  METHODS
  Register study with data from the Medical Birth Registry and the Swedish Register of Education.
  
  
  METHODS
  Use of EDA during vaginal delivery.
  
  
  RESULTS
  A total of 47,810 women (45%) received EDA during labor. EDA was used more often in women who were either young or short, had a high body mass index or a short education, or gave birth to an infant with high birthweight. After adjustment, the positive correlation with birthweight persisted. The use of EDA was twice as high in women with infant birthweight >4,500 g, 60% higher in those with infants weighing between 4,000 and 4,500 g and 25% lower when infants weighed <3,000 g, when compared to those with newborns weighing between 3,000 and 3,500 g.
  
  
  CONCLUSIONS
  The woman's need for EDA is strongly related to birthweight. Prolonged duration of labor and instrumental delivery usually ascribed to EDA may be due to large infants.
authors.affiliation: Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden. cecilia.ekeus@ki.se
authors.forename: Cecilia
authors.initials: C
authors.lastname: Ekéus
authors.forename: Anders
authors.initials: A
authors.lastname: Hjern
authors.forename: Anna
authors.initials: A
authors.lastname: Hjelmstedt
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000706:statistics & numerical data*; D001724:Birth Weight / Q000502:physiology*; D001827:Body Height / Q000502:physiology*; D015992:Body Mass Index; D004522:Educational Status; D005260:Female; D005320:Fetal Macrosomia / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D010298:Parity; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome; D012042:Registries; D012307:Risk Factors