Perinatal outcomes of newborns born from young mothers with epidural analgesia

• Main Authors: R. T. Shakirov, S. V. Kinzhalova, R. A. Makarov, S. V. Bychkova, N. V. Putilova, O. E. Gayeva, N. V. Mamovich
• Format: Article
• Language: Russian
• Published: Ltd. “The National Academy of Pediatric Science and Innovation” 2021-07-01
• Series: Rossijskij Vestnik Perinatologii i Pediatrii
• Subjects: newborns; young pregnant women; labor pain relief; epidural analgesia; acid-base state; perinatal outcomes
• Online Access: https://www.ped-perinatology.ru/jour/article/view/1417

Objective. To evaluate the features of the course of the early neonatal period of newborns born from young women under conditions of epidural analgesia.Material and methods. The authors conducted a prospective, comparative, randomized, longitudinal, monocenter study. Patients of Group 1 (n=25) were anesthetized with a narcotic analgesic (2% Тrimeperedine 1,0 ml intramuscularly). Patients of Group 2 (n=30) received long-term epidural analgesia (EA) with 0,2% Ropivacaine (10,0 ml/hour). All patients delivered full-term infants. The course of labor, clinical and laboratory characteristics of newborns in the early neonatal period were evaluated.Results. There were no significant differences in the duration of labor, volume of blood loss, and other characteristics between the groups. There were no clinical differences between the groups of newborns. We did not find a negative effect of epidural analgesia on the Apgar score at the 1st (p=0,166) and 5th (p=0,217) minutes of life and the neuropsychiatric status of the newborn (p=0,322). At the same time, in the group of long-term epidural analgesia, there was a tendency to a higher incidence of moderate and mild asphyxia (19,2% versus 9,5%; p=0,436). When comparing the acid-base state of umbilical cord arterial blood, significant differences were found in the following indicators: lower pH (p=0,042) and pO2 level (p=0,007) and higher pCO2 level (p=0,031) in arterial cord blood.Conclusion. Epidural analgesia during labor in young women is accompanied by a lower level of pH and pO2 and a higher level of pCO2 in the arterial cord blood as compared to a Group of Тrimeperedine, which indicates a more pronounced shift in the acid-base state of the fetal blood. When analyzing neurological outcomes in newborns, there were no statistically significant differences. However, further follow-up is required for children born from young mothers who have received long-term epidural analgesia in labor.