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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: The dynamics of epidural and opioid analgesia during labour
Authors: Zondag, Dirkje C.
Gross, Mechthild Maria
Grylka-Baeschlin, Susanne
Poat, Angela
Petersen, Antje
DOI: 10.21256/zhaw-4281
Published in: Archives of Gynecology and Obstetrics
Volume(Issue): 294
Issue: 5
Pages: 967
Pages to: 977
Issue Date: 2016
Publisher / Ed. Institution: Springer
ISSN: 0932-0067
Language: English
Subjects: Combined analgesia; Cox regression; Labour duration; Longitudinal studies; Spontaneous birth; Timing of interventions; Pregnancy
Subject (DDC): 618.4: Childbirth
Abstract: Purpose: To investigate the association of analgesia, opioids or epidural, or the combination of both with labour duration and spontaneous birth in nulliparous women. Methods: A secondary data analysis of an existing cohort study was performed and included nulliparous women (n = 2074). Durations of total labour and first and second labour stage were calculated with Kaplan-Meier estimation for the four different study groups: no analgesia (n = 620), opioid analgesia (n = 743), epidural analgesia (n = 482), and combined application (n = 229). Labour duration was compared by Cox regression while adjusting for confounders and censoring for operative births. Logistic regression was used to investigate the association between the administration of different types of analgesia and mode of birth. Results: Most women in the combined application group were first to receive opioid analgesia. Women with no analgesia had the shortest duration of labour (log rank p < 0.001) and highest chance of a spontaneous birth (p < 0.001). If analgesia was administered, women with opioids had a shorter first stage (p = 0.018), compared to women with epidural (p < 0.001) or women with combined application (p < 0.001). Women with opioids had an increased chance to reach full cervical dilatation (p = 0.006). Women with epidural analgesia (p < 0.001) and women with combined application (p < 0.001) had a prolonged second stage and decreased chance of spontaneous birth compared to women without analgesia. Conclusions: Women with opioids had a prolonged first stage, but increased chance to reach full cervical dilatation. Women with epidural analgesia and women with both opioid and epidural analgesia had a prolonged first and second stage and a decreased chance of a spontaneous birth.
Further description: Erworben im Rahmen der Schweizer Nationallizenzen (
Fulltext version: Published version
License (according to publishing contract): Licence according to publishing contract
Restricted until: 2021-12-01
Departement: Health Professions
Organisational Unit: Institute of Midwifery (IHB)
Appears in Collections:Publikationen Gesundheit

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