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Background <p>The impact of epidural analgesia use in the second delivery among women with a prior epidural on maternal and neonatal outcomes remains unclear.</p> Methods <p>A retrospective study was conducted to assess the impact of epidural analgesia use in the second delivery among women with a prior epidural on maternal and neonatal outcomes between July 1, 2016 and December 31, 2023. Demographic information, as well as gestational and delivery characteristics, were obtained from the hospital’s electronic health record system. Multivariable linear and logistic regression models were employed to assess the association between epidural analgesia use among multiparous women with a prior labor epidural exposure and maternal and neonatal outcomes.</p> Results <p>A total of 1827 women were included for analysis. The total duration of labor and the duration of first-second stage of labor were significantly longer in labor epidural analgesia group than in the non-labor epidural analgesia group (342.3 ± 140.9&#xa0;min vs. 273.9 ± 114.6&#xa0;min, <i>p</i> &lt; 0.001; 336.2 ± 140.9&#xa0;min vs. 267.9 ± 114.4&#xa0;min, <i>p</i> &lt; 0.001, respectively). Neither neonatal asphyxia nor NICU admission occurred in either group. Labor epidural analgesia was independently associated with prolonged the total duration of labor (β 68.01, 95% CI 55.35–80.67, <i>p</i> &lt; 0.001) and the duration of first-second stage of labor (β 67.92, 95% CI 55.26–80.57, <i>p</i> &lt; 0.001). Additionally, labor epidural analgesia was associated with a significantly increased length of stay (β 0.31, 95% CI 0.19–0.43, <i>p</i> &lt; 0.001). Labor epidural analgesia did not significantly increase the risk of assisted delivery (aOR 0.4, 95% CI 0.07–2.28, <i>p</i> = 0.3), postpartum hemorrhage (aOR 0.98, 95% CI 0.52–1.84, <i>p</i> = 0.954) and postpartum complications (aOR 2.63, 95% CI 0.75–9.22, <i>p</i> = 0.131).</p> Conclusion <p>Epidural analgesia use in the second delivery among women with a prior epidural was associated with increased length of labor and extended hospital length of stay. However, it did not increase the rates of assisted delivery, postpartum hemorrhage, or postpartum complications.</p>

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Association between epidural analgesia in the second delivery among women with a prior epidural and maternal and neonatal outcomes: a retrospective cohort study

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  • 发表日期：

    2026年8月5日

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  • Yongsheng Zhang,
  • Shili Su,
  • Qianqian Li,
  • Mingqiang Zhao,
  • Shuzhi Luo

摘要

Background

The impact of epidural analgesia use in the second delivery among women with a prior epidural on maternal and neonatal outcomes remains unclear.

Methods

A retrospective study was conducted to assess the impact of epidural analgesia use in the second delivery among women with a prior epidural on maternal and neonatal outcomes between July 1, 2016 and December 31, 2023. Demographic information, as well as gestational and delivery characteristics, were obtained from the hospital’s electronic health record system. Multivariable linear and logistic regression models were employed to assess the association between epidural analgesia use among multiparous women with a prior labor epidural exposure and maternal and neonatal outcomes.

Results

A total of 1827 women were included for analysis. The total duration of labor and the duration of first-second stage of labor were significantly longer in labor epidural analgesia group than in the non-labor epidural analgesia group (342.3 ± 140.9 min vs. 273.9 ± 114.6 min, p < 0.001; 336.2 ± 140.9 min vs. 267.9 ± 114.4 min, p < 0.001, respectively). Neither neonatal asphyxia nor NICU admission occurred in either group. Labor epidural analgesia was independently associated with prolonged the total duration of labor (β 68.01, 95% CI 55.35–80.67, p < 0.001) and the duration of first-second stage of labor (β 67.92, 95% CI 55.26–80.57, p < 0.001). Additionally, labor epidural analgesia was associated with a significantly increased length of stay (β 0.31, 95% CI 0.19–0.43, p < 0.001). Labor epidural analgesia did not significantly increase the risk of assisted delivery (aOR 0.4, 95% CI 0.07–2.28, p = 0.3), postpartum hemorrhage (aOR 0.98, 95% CI 0.52–1.84, p = 0.954) and postpartum complications (aOR 2.63, 95% CI 0.75–9.22, p = 0.131).

Conclusion

Epidural analgesia use in the second delivery among women with a prior epidural was associated with increased length of labor and extended hospital length of stay. However, it did not increase the rates of assisted delivery, postpartum hemorrhage, or postpartum complications.