Association between epidural analgesia in the second delivery among women with a prior epidural and maternal and neonatal outcomes: a retrospective cohort study.
5 affiliations
- 1Qingdao Medical College, Qingdao University, Qingdao, China.
- 2Department of Anesthesiology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China.
- 3Department of Reproductive medicine center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China.
- 4Department of Obstetrics and Gynecology, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China.
- 5Department of Anesthesiology, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China. [email protected].
Abstract
Background
The impact of epidural analgesia use in the second delivery among women with a prior epidural on maternal and neonatal outcomes remains unclear.Methods
A retrospective study was conducted to assess the impact of epidural analgesia use in the second delivery among women with a prior epidural on maternal and neonatal outcomes between July 1, 2016 and December 31, 2023. Demographic information, as well as gestational and delivery characteristics, were obtained from the hospital's electronic health record system. Multivariable linear and logistic regression models were employed to assess the association between epidural analgesia use among multiparous women with a prior labor epidural exposure and maternal and neonatal outcomes.Results
A total of 1827 women were included for analysis. The total duration of labor and the duration of first-second stage of labor were significantly longer in labor epidural analgesia group than in the non-labor epidural analgesia group (342.3 ± 140.9 min vs. 273.9 ± 114.6 min, p < 0.001; 336.2 ± 140.9 min vs. 267.9 ± 114.4 min, p < 0.001, respectively). Neither neonatal asphyxia nor NICU admission occurred in either group. Labor epidural analgesia was independently associated with prolonged the total duration of labor (β 68.01, 95% CI 55.35-80.67, p < 0.001) and the duration of first-second stage of labor (β 67.92, 95% CI 55.26-80.57, p < 0.001). Additionally, labor epidural analgesia was associated with a significantly increased length of stay (β 0.31, 95% CI 0.19-0.43, p < 0.001). Labor epidural analgesia did not significantly increase the risk of assisted delivery (aOR 0.4, 95% CI 0.07-2.28, p = 0.3), postpartum hemorrhage (aOR 0.98, 95% CI 0.52-1.84, p = 0.954) and postpartum complications (aOR 2.63, 95% CI 0.75-9.22, p = 0.131).Conclusion
Epidural analgesia use in the second delivery among women with a prior epidural was associated with increased length of labor and extended hospital length of stay. However, it did not increase the rates of assisted delivery, postpartum hemorrhage, or postpartum complications.
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BibTeX
@article{zhang2026association,
title = {{Association between epidural analgesia in the second delivery among women with a prior epidural and maternal and neonatal outcomes: a retrospective cohort study.}},
author = {Yongsheng Zhang and Shili Su and Qianqian Li and Mingqiang Zhao and Shuzhi Luo},
journal = {BMC pregnancy and childbirth},
year = {2026},
month = aug,
doi = {10.1186/s12884-026-09758-y},
url = {https://europepmc.org/article/MED/42968059},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Association between epidural analgesia in the second delivery among women with a prior epidural and maternal and neonatal outcomes: a retrospective cohort study.
AU - Yongsheng Zhang
AU - Shili Su
AU - Qianqian Li
AU - Mingqiang Zhao
AU - Shuzhi Luo
PY - 2026
DA - 2026/08/05
JO - BMC pregnancy and childbirth
DO - 10.1186/s12884-026-09758-y
UR - https://europepmc.org/article/MED/42968059
AB - Background The impact of epidural analgesia use in the second delivery among women with a prior epidural on maternal and neonatal outcomes remains unclear.Methods A retrospective study was conducted to assess the impact of epidural analgesia use in the second delivery among women with a prior epidural on maternal and neonatal outcomes between July 1, 2016 and December 31, 2023. Demographic information, as well as gestational and delivery characteristics, were obtained from the hospital's electronic health record system. Multivariable linear and logistic regression models were employed to assess the association between epidural analgesia use among multiparous women with a prior labor epidural exposure and maternal and neonatal outcomes.Results A total of 1827 women were included for analysis. The total duration of labor and the duration of first-second stage of labor were significantly longer in labor epidural analgesia group than in the non-labor epidural analgesia group (342.3 ± 140.9 min vs. 273.9 ± 114.6 min, p < 0.001; 336.2 ± 140.9 min vs. 267.9 ± 114.4 min, p < 0.001, respectively). Neither neonatal asphyxia nor NICU admission occurred in either group. Labor epidural analgesia was independently associated with prolonged the total duration of labor (β 68.01, 95% CI 55.35-80.67, p < 0.001) and the duration of first-second stage of labor (β 67.92, 95% CI 55.26-80.57, p < 0.001). Additionally, labor epidural analgesia was associated with a significantly increased length of stay (β 0.31, 95% CI 0.19-0.43, p < 0.001). Labor epidural analgesia did not significantly increase the risk of assisted delivery (aOR 0.4, 95% CI 0.07-2.28, p = 0.3), postpartum hemorrhage (aOR 0.98, 95% CI 0.52-1.84, p = 0.954) and postpartum complications (aOR 2.63, 95% CI 0.75-9.22, p = 0.131).Conclusion Epidural analgesia use in the second delivery among women with a prior epidural was associated with increased length of labor and extended hospital length of stay. However, it did not increase the rates of assisted delivery, postpartum hemorrhage, or postpartum complications.
SN - 1471-2393
ER -