title: Retrospective study of the association between epidural analgesia during labour and complications for the newborn.
abstract: OBJECTIVE
  our objective was to determine the association between epidural analgesia and different variables.
  
  
  BACKGROUND
  the effect on newborns of epidural analgesia administered to the mother during labour remains under debate.
  
  
  METHODS
  this association was retrospectively investigated in a cohort of 2399 children born in a Spanish public hospital. Only full-term (>37 weeks of gestation) deliveries were included. Other exclusion criteria were: induced delivery (medical or obstetric indication), elective caesarean section, or the presence of an important pregnancy risk factors (hypertension, diabetes, severe disease, toxaemia, retarded intrauterine growth, chronologically prolonged pregnancy, prolonged membrane rupture (>24 hours), oligoamnios, or polyhydramnios). The Mann-Whitney U test and Fisher׳s exact test were applied to determine the relationship between variables.
  
  
  CONCLUSIONS
  Apgar index values at one minute and five minutes were slightly but significantly lower in neonates whose mothers had received epidural analgesia. Neonatal intensive care unit admission was significantly more frequent in the epidural versus non-epidural group. Resuscitation was significantly more frequent in the epidural versus non-epidural group. Early breast feeding onset was more frequent in the non-epidural group. The adverse effect of epidural analgesia on early lactation remained significant after adjusting for NICU admission and the need for resuscitation in a logistic regression analysis. Epidural analgesia may have adverse effects on newborns, although the risks are low, and further research is required to elucidate the causal nature of this relationship.
authors.affiliation: Hospital ‛San Juan de la Cruz', Úbeda, Jaén, Servicio Sanitario Público Andaluz, Junta de Andalucía, Spain; Health Sciences Group BIO277, Department of Nursing, University of Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Herrera-Gómez
authors.affiliation: Health Sciences Group BIO277, Department of Nursing, University of Granada, Spain; Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, Spain.
authors.forename: O
authors.initials: O
authors.lastname: García-Martínez
authors.affiliation: Health Sciences Group BIO277, Department of Nursing, University of Granada, Spain; Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ramos-Torrecillas
authors.affiliation: Health Sciences Group BIO277, Department of Nursing, University of Granada, Spain; Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, Spain.
authors.forename: E
authors.initials: E
authors.lastname: De Luna-Bertos
authors.affiliation: Health Sciences Group BIO277, Department of Nursing, University of Granada, Spain; Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, Spain; Institute of Neuroscience, University of Granada, Spain. Electronic address: crr@ugr.es.
authors.forename: C
authors.initials: C
authors.lastname: Ruiz
authors.affiliation: Department of Statistics and Operations Research, School of Pharmacy, University of Granada, Spain.
authors.forename: F M
authors.initials: FM
authors.lastname: Ocaña-Peinado
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects*; D002585:Cesarean Section / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D048949:Labor Pain / Q000150:complications / Q000188:drug therapy; D007774:Lactation / Q000187:drug effects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D012189:Retrospective Studies
keywords: Apgar score; Breast feeding; Childbirth; Epidural analgesia; Labour; Parturition