title: Epidural analgesia during labor: impact on delivery outcome, neonatal well-being, and early breastfeeding.
abstract: BACKGROUND
  The effect of epidural analgesia on labor and effective breastfeeding is still being debated. The aim of this study is to define its impact on the trend of labor, the newborns' well-being, and early breastfeeding.
  
  
  METHODS
  We considered first-term physiologic pregnant women who delivered by the vaginal route. We divided them into two groups: group A received epidural analgesia during labor, whereas group B received no analgesia. We recorded maternal age, gestational age, modality of delivery, length of labor, and length of active labor. All newborns received skin-to-skin contact; early breastfeeding was encouraged. We recorded data on birth weight and length, Apgar score at minutes 1 and 5, type of crying, neonatal reactivity, and time between birth and exposure to the breast. Statistical significance was considered for p<0.05.
  
  
  RESULTS
  Of 934 pregnant women who delivered by the vaginal route, 317 patients required labor analgesia, and 245 patients agreed to participate in our study. Only 128 patients met inclusion criteria. We randomized them in 64 women in group A and 64 women in group B. Data on maternal age, gestational age, type of delivery, neonatal birth weight and length, and Apgar score showed no significant differences. Total length of labor was 363.58±62.20 minutes in Group A versus 292.30±64.75 minutes in group B (p<0.001). The length of active labor showed no significant difference. Among neonatal parameters we found a statistically significant difference only for length of first breastfeeding, with a mean duration of <30 minutes in 62.2% in group A versus 29.3% in Group B (p<0.001).
  
  
  CONCLUSIONS
  Epidural analgesia has little effect on trend of labor and duration of first breastfeed and none on neonatal outcome. A new protocol of epidural analgesia may solve these side effects.
authors.affiliation: Department of Gynecological Sciences and Human Reproduction, University of Padua, Padua, Italy. salvatoregizzo@libero.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gizzo
authors.forename: Stefania
authors.initials: S
authors.lastname: Di Gangi
authors.forename: Carlo
authors.initials: C
authors.lastname: Saccardi
authors.forename: Tito Silvio
authors.initials: TS
authors.lastname: Patrelli
authors.forename: Gianluca
authors.initials: G
authors.lastname: Paccagnella
authors.forename: Laura
authors.initials: L
authors.lastname: Sansone
authors.forename: Favaron
authors.initials: F
authors.lastname: Barbara
authors.forename: Donato
authors.initials: D
authors.lastname: D'Antona
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Nardelli
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000009:adverse effects / Q000379:methods; D001724:Birth Weight / Q000187:drug effects; D001942:Breast Feeding / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009035:Mothers; D010121:Oxytocin / Q000008:administration & dosage; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D010121:Oxytocin