Epidural anesthesia during childbirth - retrospective analysis of maternal and neonatal results

In Poland, in accordance with applicable regulations, every woman should have access to epidural anesthesia. The advantage of this type of analgesia is primarily analgesic effectiveness. The aim of the study is to identify variables related to epidural anesthesia and to verify the relationship between them and the occurrence of perinatal complications in the mother and the child.

This was a single-center retrospective cohort study. Electronic documentation of patients of the Hospital of St. Sofia in Warsaw was used to create an anonymous retrospective database of all births in the years 2015-2020. 27,340 cases were qualified for the analysis.

The logistic regression model showed that the risk of episiotomy (OR = 5.539; CI = 5.169-5.935) increases more than fivefold and perineal laceration (OR = 2.190; CI= 2.036-2.356) increases twice in the case of epidural anesthesia application. There is also an increased risk of operative delivery (OR = 2.668; CI = 2.255-3.156), at the same time the risk of performing a cesarean section decreases more than fivefold (OR = 0.043; CI = 0.036-0.052).

Epidural anesthesia affects the delivery mechanism leading to an increase in the number and intensity of additional medical procedures - episiotomy, perineal laceration, operative delivery. The rationale for the routine use of this method of anesthesia should be considered in the context of the implications for the woman's reproductive health and research on the effectiveness of other methods of birth anesthesia should be conducted.