Continuous epidural analgesia for painless labor does not increase the incidence of cesarean delivery.

Abstract

Continuous epidural analgesia is a popular technique provided for labor pain relief. However, the possible association between epidural analgesia and increased rate of cesarean delivery is always a concern. The purpose of this study was to explore if epidural analgesia would affect the rate of cesarean delivery in healthy term parturient women. A retrospective review of obstetric records of 822 parturients was done to compute the proportions and odds ratio of cesarean delivery between parturients receiving epidural analgesia for labor pain relief and those not receiving. Results indicated that the overall proportion of cesarean delivery was 11.1% in the epidural group as against 16.2% in the control group and the odds ratio was 0.65 (95% confidence interval: 0.37 to 1.08). The difference between groups was not statistically significant. However, for nulliparous women alone, the proportions of cesarean delivery were 11.6% and 25.1% in exposure group and control group respectively. The odds ratio was 0.39 (95% CI: 0.20 to 0.71). This difference was statistically significant. The findings may support the conclusion that continuous epidural analgesia for pain relief during labor would not increase the rate of cesarean delivery. In contrast, it may reduce this risk in nulliparas.