Authors: Chinami Tone et al
International Journal of Obstetric Anesthesia
Highlights
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Assisted reproductive technology is not independently associated with maternal satisfaction.
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Higher labor pain is associated with lower maternal satisfaction with labor epidural analgesia.
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Short and prolonged anesthesia duration are linked to lower maternal satisfaction.
Background
Maternal satisfaction with neuraxial labor analgesia is influenced by patient-specific factors such as expectations and anxiety, labor characteristics including pain intensity and labor progression, and anesthetic factors. Whether conception method influences satisfaction remains unclear. We hypothesized that women who conceived through assisted reproductive technology might have lower satisfaction than those who conceived spontaneously, based on differences in expectations, biopsychosocial factors, and obstetric interventions that may influence satisfaction with labor analgesia.
Methods
This retrospective single-center study conducted in Japan (March 2023 to December 2024) included women with term singleton pregnancies who delivered with neuraxial labor analgesia. Cases were categorized by conception methods (spontaneous vs. assisted reproductive technology). The primary outcome was maternal satisfaction with labor epidural analgesia, assessed on postpartum day one using a 0–10 scale and categorized as higher (≥9) or lower (<9). Multivariable logistic regression analysis was performed, adjusting for maternal characteristics, labor progression, anesthesia-related variables, and clinical interventions.
Results
A total of 1102 cases were analyzed, including 230 (21%) conceived with assisted reproductive technology. Though satisfaction was higher in the spontaneous pregnancy group (median 10 [9–10] vs. 10 [8–10], P = 0.004), assisted reproductive technology was not statistically significantly associated with lower satisfaction (odds ratio 1.36, 95% confidence interval 0.95–1.97). Higher pain scores, analgesia duration <120 min or ≥ 600 min, and epidural catheter replacement were associated with lower satisfaction.
Conclusions
Maternal satisfaction with neuraxial labor analgesia was not statistically significantly associated with assisted reproductive technology after adjustment for obstetric and intrapartum factors.