Outcomes of labor epidural analgesia among women aged over 40: A single‐institution retrospective study

• DOI: 10.1111/jog.13109
• Publication Date: 2016-09-19T12:16:52Z
• Authors: Atsuko Okazaki; Risa Fukushima; Sayuri Nagashima; Yusuke Mazda; Kazumi Tamura; Katsuo Terui; Motoshi Tanaka
• Keywords: Adult; Labor, Obstetric; Adolescent; Age Factors; Infant, Newborn; Pregnancy Outcome; Gestational Age; Middle Aged; 3. Good health; Analgesia, Epidural; Young Adult; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Pregnancy; Analgesia, Obstetrical; Humans; Female; Infant Health; Retrospective Studies

AbstractAimThe purpose of this study was to investigate the effects of labor epidural analgesia (LEA) on maternal and neonatal outcomes among parturients aged 40 years or older.MethodsWe retrospectively reviewed medical records of all laboring, singleton and cephalic deliveries at ≥36 weeks' gestation at the Saitama Medical Center from April 2003 to September 2012. Women aged ≥40 years who received LEA (≥40 with LEA group) were compared with women aged ≥40 years who delivered without LEA (≥40 without LEA group) and women <40 years who received LEA (<40 with LEA group). Extracted outcomes included mode of delivery, oxytocin augmentation, duration of labor, amount of estimated blood loss, umbilical artery pH, Apgar scores, and neonatal intensive care unit admission.ResultsThis study included 4441 women. There were 74 women in the ≥40 with LEA group, 369 in the ≥40 without LEA group, and 601 in the <40 with LEA group. The maternal outcomes of emergency cesarean delivery rate (9.5%, 12.5%, 9.0%), instrumental delivery rate (33.8%, 10.3%, 28.3%), duration of labor (521 min, 321 min, 565 min), and estimated blood loss (524 g, 351 g, 412 g) were reported for the ≥40 with LEA, ≥40 without LEA, and <40 with LEA groups, respectively. Neonatal outcomes were not different between these groups. LEA use was not associated with emergency cesarean delivery in the multivariable analysis.ConclusionOur study showed that parturients aged ≥40 with LEA can expect similar LEA‐associated labor outcomes to younger parturients with LEA.