Labor epidural analgesia among Han and Uyghur parturients: a prospective observational study in China

Disparities in pain sensitivity and tolerance have been described, however little is known about variability in the experience of labor pain and childbirth in China.

This prospective observational study was conducted at a tertiary hospital in Xinjiang, China with two major ethnic groups: Han and Uyghur women. Women with a vaginal delivery with labor epidural analgesia were enrolled. The primary outcome was cervical dilation at labor epidural analgesia request, and multivariable linear regression analysis was performed to determine associated variables. Secondary outcomes were pain score at epidural request and epidural analgesics use. Data presented as mean ± standard deviation.

Cervical dilatation at labor epidural analgesia request was significantly lower (1.2 ± 0.7 vs. 0.8 ± 0.6 cm; P=0.0095), and pain score (numerical pain scale 0-10) was significantly higher (0.8 ± 1.0 vs. 4.2 ± 1.2; P=0.0002) among Uyghur compared to Han women. In the multivariate model, Uyghur women had a lower cervical dilation (P=0.0392) and a higher pain score (P <0.0001) at epidural request. During the labor process, a larger proportion of Uyghur women used the patient-controlled epidural analgesia (PCEA) pump (77.8% vs. 53.6%, P=0.0011). They pressed the pump in a significantly shorter time (61.3 ± 41.2 vs. 104.0 ± 105.2 min, P=0.0015) and for more times (1.9 ± 1.7 vs. 1.2 ± 1.4, P=0.0022), contributing to significantly more epidural analgesic use (sufentanil: 0.06 ± 0.02 vs. 0.07 ± 0.03 μg/kg/h, P=0.0150, ropivacaine: 0.11 ± 0.04 vs. 0.14 ± 0.06 mg/kg/h, P=0.0003, respectively).

Our findings suggest that Uyghur women experience labor pain with higher levels of pain and with higher use of epidural analgesics than Han women. Further studies are needed to evaluate whether these differences are clinically relevant.