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首页> 外文期刊>Biological research for nursing >The Effect of Epidural Analgesia Alone and in Association With Other Variables on the Risk of Cesarean Section
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The Effect of Epidural Analgesia Alone and in Association With Other Variables on the Risk of Cesarean Section

机译：硬膜外镇痛的影响及其与其他变量与剖宫产风险的影响

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Introduction: Epidural analgesia (EA) is the most widespread pharmacologic method of labor pain relief. There remains disagreement, however, regarding its adverse effects. The objective of this study was to determine the effect of EA administration on the risk of cesarean delivery and its causes (e.g., stalled labor, risk of loss of fetal well-being, among others) and the degree to which this effect may be modulated by mother-, newborn-, and labor-related variables. Method: A retrospective cohort observational study was conducted including all deliveries in a Spanish public hospital between March 2010 and March 2013 (N = 2,450; EA = 562, non-EA = 1,888). Results: Risk of a cesarean section was significantly increased by EA administration (odds ratio [OR] = 2.673; p < .0001). The percentage of cesarean deliveries due to the risk of loss of fetal well-being was significantly higher in the EA (47.8%) versus non-EA group (27.5%; OR = 1.739; p = 0.0012,). The EA-associated risk of cesarean section was not significantly modified as a function of maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration alone. However, these variables in combination may increase the risk. We present multivariate models for each group that account for these variables, allowing for estimation of the risk of a cesarean delivery if EA is administered. Conclusion: EA is associated with an increased risk of cesarean delivery. Other variables in combination (maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration) may increase this risk.
机译：简介：硬膜外镇痛（EA）是植物疼痛缓解的最广泛的药理学方法。然而，关于其不利影响，仍有分歧。本研究的目的是确定EA给管理对剖宫产的风险及其原因的影响（例如，停滞的劳动力，胎儿福祉损失的风险）以及可能调制这种效果的程度通过母亲，新生儿和劳动相关的变量。方法：进行了回顾性队列观察研究，包括2010年3月至2013年3月的西班牙公立医院的所有交付（n = 2,450; ea = 562，非EA = 1,888）。结果：EA给药（差距[或] = 2.673; P <0.0001），剖宫产的风险显着增加。由于胎儿福祉损失的风险导致的剖腹产的百分比在EA（47.8％）与非EA组（27.5％;或= 1.739; P = 0.0012）中显着高。单独的孕妇年龄或奇偶校验，胎儿，新生儿重量，妊娠或单独镇静管理的函数没有显着修饰。然而，组合组合的这些变量可能会增加风险。我们为每个占这些变量的组提供多变量模型，允许估计剖腹产的风险，如果ea被施用。结论：EA与剖腹产的风险增加。其他变量组合（母体年龄或奇偶诊断，胎儿位置，新生重量，妊娠周或镇静剂给药）可能会增加这种风险。

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