Commentary: 'Retrospective study of the association between epidural analgesia during labour and complications for the newborn'. Issue 12 (December 2015)

• Record Type: Journal Article
• Authors: García-Mejido, José Antonio
• Is Part Of: Midwifery. Volume 31:Issue 12(2015)
• Page Start: e103
• Publication Date: 2015-12
• Subjects: Midwifery -- Periodicals; Midwifery -- Periodicals; Sages-femmes -- Périodiques; Midwifery; Periodicals; Electronic journals; 618.2005
• DOI: 10.1016/j.midw.2015.09.004
• Languages: English
• ISSNs: 0266-6138

Abstract

Abstract : As stated in the study by XXXXXX, epidural analgesia has been an important step in the evolution of obstetrics. The main objective of the study, where adverse effects are identified in the newborn associated with use of the epidural analgesia, is paramount for obstetrical work. However, the methodology used is not the most appropriate for the authors conclusions. Inclusion criteria have been used trying to rule out those patients with breast pathology that could influence the behaviour of the newborn. However, other factors have not been reflected which may influence the Apgar and the need for admission of an infant to the neonatal unit for example: instrumental delivery, the reasons for the needing an instrumental birth, CTG recording prior to delivery, need for oxytocin during labour, time of second stage of labour, intrapartum fever, the need for antibiotics, if women were recorded as having group B streptococcus, time since membranes ruptured, infant birthweight. Instrumental delivery is most often associated with epidural analgesia. This fact, as well as any of the above factors may cause bias resulting in erroneous results. Therefore, the findings of this study may have been distorted as a result of the study design. Personally I congratulate the authors for attempting such a controversial issue as epidural anaesthesia on neonatal outcome. I encourage you to perform a multivariate analysis of all factors that influence neonatal outcome in the population considered, to establish whether the epidural is an influential factor in neonatal complications.