Effects of epidural and systemic maternal analgesia in term infants: the NoPiL study.
The aim of the No Pain in Labour (NoPiL) study was to evaluate the stress and clinical outcome of infants vaginally born without maternal analgesia and after maternal epidural or systemic analgesia. We studied 120 healthy term infants, 41 in the no analgesia group, 38 in the epidural analgesia group, and 41 in the systemic analgesia group. Cortisol, beta-endorphin, oxidative stress markers (ie: total hydroperoxide (TH) and advanced oxidation protein products (AOPP)), interleukin-1beta (IL-1beta), and interleukin-8 (IL-8) cytokines were measured in arterial cord blood samples. Infants in the 3 groups had similar Apgar score, cord blood pH and occurrence of hypoglycaemia, hyperbilirubinemia, and respiratory depression. Cortisol and endorphin plasma levels did not differ in the groups, nor did TH and AOPP values. IL-1beta and IL-8 cytokine were higher in infants born after maternal epidural analgesia than in other groups. Short-term outcome and stress were similar in infants vaginally born without maternal analgesia and after epidural and systemic analgesia. The possible implications of the highest interleukin levels in the epidural analgesia group deserve further study.
Department of Surgical and Medical Critical Care, Section of Neonatology, University Hospital of Florence, Florence, Italy. cdani@unifi.It
Carlo
C
Dani
Silvia
S
Perugi
Giulia
G
Fontanelli
Giovanna
G
Bertini
Simone
S
Pratesi
Giuseppe
G
Buonocore
Mariangela
M
Longini
Fabrizio
F
Proietti
Cosetta
C
Felici
Riccardo
R
Ciuti
Paola
P
D'Onofrio
Annamaria Melani
AM
Novelli
Marco
M
Pezzati
Davide
D
Gambi
Gianfranco
G
Scarselli
Alessandro
A
Frigiola
Alessandro
A
Giamberti
Raul
R
Abella
Firmino F
FF
Rubaltelli
D015360:Analgesia, Epidural; D000700:Analgesics / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007231:Infant, Newborn; D007375:Interleukin-1 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D018811:Maternal Exposure; D018384:Oxidative Stress; D011247:Pregnancy; D001615:beta-Endorphin / Q000097:blood
D000700:Analgesics; D007375:Interleukin-1; D016209:Interleukin-8; D001615:beta-Endorphin; D006854:Hydrocortisone