PMID: 8942841Dec 1, 1996Paper

Association of epidural analgesia with cesarean delivery in nulliparas

Obstetrics and Gynecology
E LiebermanF Frigoletto

Abstract

To evaluate whether epidural analgesia during the first stage of labor is associated with an increased risk of cesarean delivery. The association of epidural analgesia and cesarean delivery was examined in a retrospective study of 1733 low-risk, term nulliparas with singleton infants in vertex presentations, in which labor began spontaneously. To evaluate the effect of epidural analgesia on cesarean deliveries, independent of other factors influencing the use of epidural analgesia, we used propensity scores to create five subgroups (quintiles) of women who, based on characteristics discernible at admission, appeared equally likely to receive epidural analgesia. Multivariate logistic regression analysis was used to control for confounding. Overall, the cesarean rate among women receiving epidural analgesia was 17% (168 of 991), compared with 4% (30 of 742) among those who did not receive epidural analgesia. An increased cesarean rate among women receiving epidural analgesia was present in all propensity quintiles. In an adjusted logistic regression analysis, women receiving epidural analgesia were 3.7 times more likely to undergo a cesarean (95% confidence interval 2.4, 5.7). The greatest increase in cesarean risk was noted when...Continue Reading

Associated Clinical Trials

Apr 28, 2017·MARIA BELEN RODRIGUEZ-CAMPOO

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