{
    "abstract": "The mechanism underlying maternal fever and prolonged labor progression associated with neuraxial analgesia (NA) remains elusive, raising concerns among certain pregnant women regarding the application of NA during vaginal delivery. This study aimed to investigate the impact of early and late NA on maternal and neonatal outcomes in multiparous women.\nThis retrospective study collected data from 1119 multiparous women with singleton pregnancies, full term and live births at our labor and delivery center between August 1st, 2021 and July 31st, 2022. Based on the timing of NA initiation, participants were categorized into three groups: no-NA, early-NA and late-NA. The no-NA group comprised of 172 women who did not receive NA during vaginal delivery; the early-NA group included 603 women in which NA was initiated when cervical dilation was between 0.5 and 2.0\u00a0cm; and the late-NA group comprising 344 cases in which NA was initiated at the cervical dilation of \u2265\u20092\u00a0cm. Maternal and neonatal outcomes were observed, including durations of the first, second, third and total stage of labor, the rate of intrapartum cesarean delivery (CD), intrapartum fever, postpartum hemorrhage (PPH), transfer to intensive care unit (ICU), admission to the neonatal intensive care unit (NICU), meconium-stained amniotic fluid, and neonatal Apgar scores at 1 and 5\u00a0min.\nNo differences were noted in the maternal age, body mass index (BMI) on admission, gestations, parity, gestational weeks at delivery and neonatal birth weight, or the rate of gestational diabetes mellitus (GDM) and hypertension disorder did not significantly differ among the three groups (p\u2009>\u20090.05). The no-NA group had shorter durations of first stage, second stage of labor compared to the early-NA or late-NA group (median, 215.0\u00a0min and 10.0\u00a0min vs. 300.0\u00a0min and 12.0\u00a0min vs. 280.0\u00a0min and 13.0\u00a0min) (p\u2009<\u20090.05), but no differences were observed between the early-NA and late-NA group (p\u2009>\u20090.05). There were no differences in the rate of intrapartum CD, intrapartum fever, PPH, maternal transferred to ICU, neonatal transfer to NICU, meconium-stained amniotic fluid, and postpartum stay\u2009\u2265\u20097d, as well as the neonatal the Apgar scores at 1 and 5\u00a0min among the three groups (p\u2009>\u20090.05).\nNA is associated with extended durations of the first, second and total stages of labor. However, the early initiation of NA in multiparous women (cervical dilation within 0.5-2.0\u00a0cm) does not increase the risk of intrapartum CD or intrapartum fever. These findings endorse the secure utilization of early NA for pain relief during labor in multiparous women.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China.\nWuhan University of Science and Technology, No. 2, Huangjiahu West Road, Hongshan District, Wuhan, 430065, China.",
            "firstname": "Wenxing",
            "initials": "W",
            "lastname": "Cheng"
        },
        {
            "affiliation": "Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China.",
            "firstname": "Chunyu",
            "initials": "C",
            "lastname": "Xiong"
        },
        {
            "affiliation": "Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China.",
            "firstname": "Hao",
            "initials": "H",
            "lastname": "Li"
        },
        {
            "affiliation": "Wuhan University of Science and Technology, No. 2, Huangjiahu West Road, Hongshan District, Wuhan, 430065, China.",
            "firstname": "Jiao",
            "initials": "J",
            "lastname": "Wen"
        },
        {
            "affiliation": "Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China.",
            "firstname": "Jing",
            "initials": "J",
            "lastname": "Peng"
        },
        {
            "affiliation": "Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China.",
            "firstname": "Shiyao",
            "initials": "S",
            "lastname": "Wu"
        },
        {
            "affiliation": "Department of Maternal and Child Health Hospital of Hubei Province, Hubei University of Medicine, Hubei University of Medicine, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China.",
            "firstname": "Haotian",
            "initials": "H",
            "lastname": "Pan"
        },
        {
            "affiliation": "Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China.",
            "firstname": "Lei",
            "initials": "L",
            "lastname": "Chen"
        },
        {
            "affiliation": "Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China. 13554330315@163.com.",
            "firstname": "Weina",
            "initials": "W",
            "lastname": "Xia"
        },
        {
            "affiliation": "Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China. zhao020060@163.com.",
            "firstname": "Yun",
            "initials": "Y",
            "lastname": "Zhao"
        }
    ],
    "conclusions": "NA is associated with extended durations of the first, second and total stages of labor. However, the early initiation of NA in multiparous women (cervical dilation within 0.5-2.0\u00a0cm) does not increase the risk of intrapartum CD or intrapartum fever. These findings endorse the secure utilization of early NA for pain relief during labor in multiparous women.",
    "copyrights": "\u00a9 2023. The Author(s).",
    "doi": "10.1186/s12871-023-02395-4\n10.1016/j.ajog.2022.06.017\n10.3389/fsurg.2022.1064272\n10.1002/iid3.869\n10.1590/1806-9282.20230500\n10.1186/s12884-020-03294-z\n10.1213/ANE.0000000000001962\n10.3390/jcm12113620\n10.1080/14767058.2023.2179383\n10.4274/TJAR.2023.221085\n10.3390/jcm11206124\n10.1016/j.xagr.2023.100207\n10.1016/j.bja.2020.09.046\n10.1097/AOG.0000000000002306\n10.1007/s00540-022-03125-9\n10.1056/NEJMoa042573\n10.1002/ijgo.14175\n10.1001/jamanetworkopen.2022.0137\n10.1007/s00404-021-06111-w\n10.5603/GP.a2021.0053\n10.1111/jog.15571",
    "journal": "BMC anesthesiology",
    "keywords": [
        "Duration of stage",
        "Intrapartum cesarean delivery",
        "Intrapartum fever",
        "Multiparous women",
        "Neuraxial analgesia"
    ],
    "methods": null,
    "publication_date": "2024-01-04",
    "pubmed_id": "38166749\n37608256\n37164496\n36647860\n36704517\n37625990\n37506154\n37466614\n33045998\n0\n28277324\n37297815\n37121901\n37587657\n37607688\n36294447\n37168548\n33218673\n29016499\n36380286\n36251094\n15716559\n35875290\n35277971\n35191971\n34061246\n33914329\n36734027",
    "results": "No differences were noted in the maternal age, body mass index (BMI) on admission, gestations, parity, gestational weeks at delivery and neonatal birth weight, or the rate of gestational diabetes mellitus (GDM) and hypertension disorder did not significantly differ among the three groups (p\u2009>\u20090.05). The no-NA group had shorter durations of first stage, second stage of labor compared to the early-NA or late-NA group (median, 215.0\u00a0min and 10.0\u00a0min vs. 300.0\u00a0min and 12.0\u00a0min vs. 280.0\u00a0min and 13.0\u00a0min) (p\u2009<\u20090.05), but no differences were observed between the early-NA and late-NA group (p\u2009>\u20090.05). There were no differences in the rate of intrapartum CD, intrapartum fever, PPH, maternal transferred to ICU, neonatal transfer to NICU, meconium-stained amniotic fluid, and postpartum stay\u2009\u2265\u20097d, as well as the neonatal the Apgar scores at 1 and 5\u00a0min among the three groups (p\u2009>\u20090.05).",
    "title": "Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study.",
    "xml": "<Element 'PubmedArticle' at 0x788506033290>"
}