In a study of vaginal births in New York State hospitals, labour neuraxial analgesia was associated with a decreased risk of severe maternal morbidity.
Deliveries with a neuraxial analgesia also lessened the risk of postpartum haemorrhage, the leading cause of preventable severe maternal morbidity, according to Jean Guglielminotti, MD, Columbia University Mailman School of Public Health, and Columbia Vagelos College of Physicians and Surgeons, New York, New York.
“Our goal was to examine the potential benefit of labour neuraxial analgesia in reducing severe maternal morbidity,” said Dr. Guglielminotti. “The findings indicate that use of labour neuraxial analgesia for vaginal deliveries is associated with a 14% reduction in severe maternal morbidity. Labour neuraxial analgesia may facilitate early evaluation and management of the third stage of labour to avoid escalation of post-partum haemorrhage into grave complications and death.”
The study, published in JAMA Network Open, showed that severe maternal morbidity occurred in 7,712 (1.3%) women, of which 2,748 (36%) had postpartum haemorrhage. Use of neuraxial analgesia for vaginal delivery was associated with a 14% decrease in the risk of severe maternal morbidity.
The study sample included hospitalisations for vaginal delivery among women aged 15 to 49 years between January 2010, and December 2017 in New York. During the study period there were 575,524 women with vaginal deliveries. Of the women, 8% were non-Hispanic Asian or Pacific Islander, 15% were non-Hispanic Black, 18% were Hispanic, 45% were non-Hispanic White, and 13% were of other race and ethnicity.
The study also found a decreased risk of severe maternal morbidity associated with neuraxial analgesia was similar between non-Hispanic White women and racial and ethnic minority women and between low-risk and high-risk women.
“Increasing the use of labour neuraxial analgesia among minority women would help narrow the racial and ethnic gap in the utilisation of obstetric anaesthesia care, likely leading to improvement in maternal health equalities,” said Dr. Guglielminotti.