Does Preferred Spoken Language Affect Time to Epidural for Nulliparous Patients? [A203

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INTRODUCTION: Some studies have observed sociodemographic disparities in administration of intrapartum epidural anesthesia. Our objective was to determine whether preferred spoken language was associated with time to epidural administration. METHODS: This was a retrospective cohort study of all nulliparous patients admitted for labor or induction at one academic hospital in New York who received intrapartum epidural analgesia prior to delivery from January to December 2019. The outcome was time to epidural, which was evaluated for English-speaking and non-English-speaking patients. For patients undergoing scheduled induction, time to epidural was defined as the interval from induction agent to epidural administration. For patients admitted in spontaneous labor, time to epidural was defined as the time interval from hospital presentation to epidural administration. Demographic and clinical data were collected. Patients in the induction and spontaneous labor groups were analyzed separately. RESULTS: A total of 417 patients were included: 215 (52%) inductions and 202 (48%) presenting in spontaneous labor. Overall, 264 (63%) patients preferred English and 153 (47%) preferred another language (primarily Spanish). In the spontaneous labor group, there was no difference in time to epidural between English-speaking and non-English-speaking patients (307 versus 272 minutes, respectively). Among scheduled inductions, time to epidural was lower for English speakers than non-English speakers (869 versus 1,100 minutes, respectively; P<.01). English-speaking patients were more likely to be induced (56% versus 43%, P<.01). Sociodemographic factors such as age, race/ethnicity, and marital status were not associated with time to epidural. CONCLUSION: Preferred language was not associated with time to epidural in the spontaneous labor group, but a significant difference was noted for patients undergoing induction. Non-English-speakers may experience delayed analgesic interventions.