Neonatal neurobehavioral organization after exposure to maternal epidural analgesia in labor.
OBJECTIVE
To explore relationships between maternal epidural analgesia and two measures of neurobehavioral organization in infants at the initial feeding 1 hour after birth.


METHODS
Prospective comparative design.


METHODS
Inner-city community hospital, Chicago, Illinois.


METHODS
Convenience sample of 52 low-risk, mainly Black and Latino, mother/infant dyads.


METHODS
Mothers self-selected to labor with epidural or no labor pain medication. Neonatal neurobehavioral organization was measured in term infants at the initial feeding 1 hour after birth. A nutritive sucking apparatus generated data on total number of sucks and sucking pressure. Video recordings of infants (before and after the initial feeding) were coded for behavioral states, with analysis on frequency of alertness.


RESULTS
Total number of sucks and sucking pressure were not related to epidural exposure, although an epidural drug dosage effect on total number of sucks was evident when gender was a factor. Unmedicated girls demonstrated more sucks than girls in the high-dosage epidural group (p=.027). Overall, girls exhibited stronger sucking pressure than boys (p=.042). Frequency of alertness was not related to epidural exposure, although longer labor was related to greater alertness (p=.003), and Latino infants were more alert than Black infants (p=.002).


CONCLUSIONS
Results suggest attenuated neonatal nutritive sucking organization in girls after exposure to high maternal epidural dosages. In comparison to boys, girls may have enhanced neurobehavioral organization at birth. Race/ethnicity and alertness may have spurious associations in which hidden factors drive the relationship.
Bell
Aleeca F
AF
University of Illinois at Chicago, College of Nursing, Department of Women, Children and Family Health Sciences, 845 South Damen, MC 802, Chicago, IL 60466, USA. abell2@uic.edu
White-Traut
Rosemary
R
Medoff-Cooper
Barbara
B
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000379:methods; D016362:Analgesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002641:Chicago; D015400:Clinical Nursing Research; D004305:Dose-Response Relationship, Drug; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn / Q000502:physiology*; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D012727:Sex Characteristics; D018709:Statistics, Nonparametric; D013391:Sucking Behavior / Q000187:drug effects* / Q000502:physiology; D013997:Time Factors; D014851:Wakefulness / Q000187:drug effects* / Q000502:physiology