Having an epidural during labor is associated with a marked reduction in serious complications in the first few weeks after giving birth, finds a study published by The BMJ today. Doctors refer to these complications as severe maternal morbidity (SMM), which can include heart attack, heart failure, sepsis, and hysterectomy. Epidural analgesia is recommended for women with known risk factors for SMM, such as obesity, certain underlying conditions, or having more than one baby.
These women are said to have a 'medical indication' for epidural analgesia in labor. Women delivering prematurely also carry a higher risk of SMM. Some research suggests that epidural analgesia in labor may reduce the risk of SMM, though evidence is limited.
To address this, a team from the University of Glasgow in collaboration with the University of Bristol set out to determine the effect of labor epidural on SMM and explore whether this was greater in women with a medical indication for epidural in labor, or those in preterm labor. Their findings are based on Scottish National Health Service data for 567,216 mothers in labor (average age 29, 93% white) delivering vaginally or via unplanned cesarean section in Scotland between 2007 and 2019. Medical records were used to identify any of the 21 conditions defined as SMM by the US Centers for Disease Control and Prevention or a critical care admission occurring at any point from date of delivery to 42 days after giving birth.
Factors such as mother's age,.