Obstetric and neonatal outcomes associated with neuraxial analgesia during labor
DOI:
https://doi.org/10.12957/reuerj.2025.82379Keywords:
Obstetric Nursing, Labor, Obstetric, Labor Pain, Analgesia, Obstetrical, Infant, NewbornAbstract
Objective: to assess obstetric and neonatal outcomes associated with the administration of neuraxial analgesia during labor. Method: a descriptive, documentary study with a quantitative approach, conducted between March and August 2022, following approval by the Research Ethics Committee. Data were analyzed using descriptive and inferential statistics. Results: among 240 laboring women, the epidural technique was the most frequently employed (87%). Vaginal delivery occurred in 70% of cases, 44.2% underwent amniotomy, 35% received oxytocin, and 10.2% experienced reduced mobility. In relation to newborns, 36.2% required medical interventions, 99% airway suctioning, 10.3% positive pressure ventilation, and 9.1% venous catheterization. Additionally, 3.3% were admitted to a neonatal intensive care unit. Conclusion: neuraxial analgesia proved to be a safe method for pain management during labor and may contribute to reducing elective cesarean deliveries. Its use did not negatively impact maternal or neonatal outcomes; however, it was associated with a higher likelihood of obstetric interventions when compared to women who did not receive it.
References
1. Mascarenhas VHA, Lima TR, Silva FMD, Negreiros FS, Santos JDM, Moura MÁP, et al. Scientific evidence on non-pharmacological methods for relief of labor pain. Acta Paul Enferm. 2019 [cited 2023 Dec 20]; 32(3):350–7. DOI: https://doi.org/10.1590/1982-0194201900048.
2. Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BI, Casey BM, et al. Obstetrícia de Williams. 24 ed. Porto Alegre: Editora AMGH; 2021.
3. Garcia-Lausin L, Perez-Botella M, Duran X, Mamblona-Vicente MF, Gutierrez-Martin MJ, Enterria-Cuesta EG, et al. Relation between length of exposure to epidural analgesia during labour and birth mode. Int J Environ Res Public Health. 2019 [cited 2023 Sep 12]; 16(16):e16162928. DOI: https://doi.org/10.3390/ijerph16162928.
4. Cunha AA, Gribel GP, Palmiro A. Analgesia e anestesia farmacológica em Obstetrícia. In: Protocolo Febrasgo – Obstetrícia, nº 98/Comissão Nacional Especializada em Assistência ao Abortamento, Parto e Puerpério. São Paulo: Federação Brasileira das Associações de Ginecologia e Obstetrícia (Febrasgo); 2018.
5. Aragão FF, Aragão PW, Martins CA, Leal KFCS, Ferraz Tobias A. Neuraxial labor analgesia: a literature review. Brazilian J Anesthesiol. 2019 [cited 2023 Dec 12]; 69(3):291–8. DOI: https://doi.org/10.1016/j.bjan.2018.12.001.
6. Penuela I, López M, Tamayo E, Almeida H, Gomez-Sanchez E, Isasi-Nebreda P. Epidural analgesia and its implications in the maternal health in a low parity community. BMC Pregnancy Childbirth. 2019 [cited 2023 Nov 25]; 19(1):52. DOI: https://doi.org/10.1186/s12884-019-2191-0.
7. Leal MC, Bittencourt SA, Esteves-Pereira AP, Ayres BVS, Silva LBRAA, Thomaz EBAF, et al. Progress in childbirth care in Brazil: preliminary results of two evaluation studies. Cad Saude Publica. 2019 [cited 2023 Dec 12]; 35(7):e00223018. DOI: https://doi.org/10.1590/0102-311X00223018.
8. Felisbino-Mendes MS, Santos LO, Amorim T, Costa IN, Martins EF. Does the use of pharmacological analgesia influence childbirth outcomes? Ascta Paul Enferm. 2017[cited 2023 Nov 16]; 30(5):458–65. DOI: https://doi.org/10.1590/1982-0194201700067.
9. Ministério da Saúde (Br). Sistema de Informações sobre Nascidos Vivos – Sinasc. 2022 [cited 2024 Feb 20]. Available from: http://sinasc.saude.gov.br/default.asp.
10. Maternidade-Escola Assis Chateaubriant. Relatório de Produção Assistencial 2023. Fortaleza: Universidade Federal do Ceará; 2023 [cited 2025 Mar 20]. Available from: https://www.gov.br/ebserh/pt-br/hospitais-universitarios/regiao-nordeste/ch-ufc/governanca/gestao-estrategica/maternidade-escola-assis-chateuaubriand/copy_of_RelatorioAssistencial202312Retificado.pdf.
11. Braga AFA, Carvalho VH, Braga FSS, Pereira RIC. Combined spinal‐epidural block for labor analgesia. Comparative study with continuous epidural block. Brazilian J Anesthesiol. 2019 [cited 2023 Dec 10]; 69(1):7–12. DOI: https://doi.org/10.1016/j.bjan.2018.08.002.
12. Guesine GD, Paschoini MC, Melo GA, Araujo Júnior E, Peixoto AB. Labor analgesia and its impact on the maternal and perinatal outcomes. Rev Assoc Med Bras. 2023 [cited 2023 Dec 10]; 69(7):e20230500. DOI: https://doi.org/10.1590/1806-9282.20230500.
13. Almeida MFB, Guinsburg R, Coordenadores Estaduais e Grupo Executivo PRN-SBP, Conselho Científico Departamento Neonatologia SBP. Reanimação do recém-nascido ≥34 semanas em sala de parto: diretrizes 2022 da Sociedade Brasileira de Pediatria. Rio de Janeiro: Sociedade Brasileira de Pediatria; 2022 2023 [cited 2023 Dec 10]. DOI: https://doi.org/10.25060/PRN-SBP-2022-2.
14. Ministério da Saúde (Br). Portaria GM/MS Nº 5.350, DE 12 DE setembro DE 2024. Altera a Portaria de Consolidação GM/MS nº 3, de 28 de setembro de 2017, para dispor sobre a Rede Alyne. 2024 [cited 2025 Mar 18]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2024/prt5350_13_09_2024.html.
15. Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins, 2017.
16. Instituto Brasileiro de Geografia e Estatística (Br). Pesquisa Nacional por Amostra de Domicílios Contínua trimestral. Rio de Janeiro: IBGE; 2020 [cited 2025 Mar 18]. Available from: https://www.ibge.gov.br/estatisticas/sociais/trabalho/9171-pesquisa-nacional-por-amostra-de-domicilios-continua-mensal.html.
17. Andrade SG, Vasconcelos YA, Carneiro ARS, Severiano ARG, Dantas TAJM, Silva TB, et al. Perfil sociodemográfico, epidemiológico e obstétrico de parturientes em um hospital e maternidade de Sobral, Ceará. Rev Prevenção Infecção e Saúde. 2018 [cited 2023 Oct 20]; 4:1–13. DOI: https://doi.org/10.26694/repis.v4i0.7283.
18. Brasil JF, Sacramento IO, Costa JLFR, Brasil LFF, Carletto MP, Lopes FFL, et al. The impact of the place of delivery, type of birth and number of antenatal visits on the apgar score. J. Health Sci. 2023 [cited 2025 Apr 15]; 25(2):83-8. Available from: https://journalhealthscience.pgsscogna.com.br/JHealthSci/article/view/10390.
19. Souza MRT, Carneiro JL, Farias LMVC, Costa CC, Vasconcelos CM, Lima MOP, et al. Neuroaxial analgesia in labor: effects on maternal and neonatal outcomes. Acta paul enferm. 2024 [cited 2025 Apr 15]; 37:eAPE02103. DOI: https://doi.org/10.37689/acta-ape/2024AO00021033.
20. Fernandes RLV, Damasceno AKC, Herculano MMS, Martins RST, Oriá MOB. Pharmacological obstetric analgesia: a study of obstetric and neonatal outcomes. Rev Rene. 2017 [cited 2025 Apr 15]; 18(5):687–94. DOI: https://doi.org/10.15253/2175-6783.2017000500017.
21. Ministério da Saúde (Br). Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Gestão e Incorporação de Tecnologias em Saúde. Diretrizes nacionais de assistência ao parto normal: versão resumida [recurso eletrônico]. Brasília (DF): Ministério da Saúde, 2017 [cited 2025 Apr 15]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_nacionais_assistencia_parto_normal.pdf.
22. Newnham EC, Moran PS, Begley CM, Carroll M, Daly D. Comparison of labor and birth outcomes between nulliparous women who used epidural analgesia in labor and those who did not: a prospective cohort study. Women Birth. 2021 [cited 2023 Oct 16]; 34(5):e435–41. DOI: https://doi.org/10.1016/j.wombi.2020.09.001.
23. Rocha BD, Zamberlan C, Pivetta HMF, Santos BZ, Antunes BS. Upright positions in childbirth and the prevention of perineal lacerations: a systematic review and meta-analysis. Rev da Esc Enferm. 2020 [cited 2023 Dec 18]; 54:e03610. DOI: https://doi.org/10.1590/S1980-220X2018027503610.
24. Sá PLC, Rabelo EM. Contato pele-a-pele mãe/filho na primeira hora de vida: uma revisão integrativa. Rev Enferm Atual Derme. 2019 [cited 2023 Dec 12]; 95(35):e-021120. Available from: https://revistaenfermagematual.com.br/index.php/revista/article/view/1079.
25. Lopes GDC, Gonçalves AC, Gouveia HG, Armellini CJ. Attention to childbirth and delivery in a university hospital: Comparison of practices developed after network stork. Rev Lat Am Enfermagem. 2019 [cited 2023 Nov 25]; 27:e3139. DOI: https://doi.org/10.1590/1518-8345.2643-3139.
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Guilherme Frederico Abdul Nour, Maíra Maria Leite de Freitas, Luana de Sousa Oliveira, Cinthia Maria Gomes da Costa Escoto Esteche, Juliana Oliveira Brito, Laura Pinto Torres de Melo, Tatiane da Silva Coelho, Ana Kelve de Castro Damasceno
This work is licensed under a Creative Commons Attribution 4.0 International License.
When publishing in Revista Enfermagem UERJ, the authors declare that the work is their exclusive authorship and therefore assume full responsibility for its content.
Authors retain copyright to their article and agree to license their work using a Creative Commons Attribution International Public License (CC BY), thereby accepting the terms and conditions of this license (https://creativecommons.org/licenses/by/4.0/legalcode.en), which allows material created by the author to be distributed, copied and displayed by third parties. The original work must be cited and present a link to the article available on the website of the journal in which it was published.
The Copyright of the articles published in Revista Enfermagem UERJ belongs to their respective author(s), with the rights of first publication assigned to Revista Enfermagem UERJ, with the work simultaneously licensed under a Creative Commons License CC BY, which allows sharing of work with recognition of authorship and initial publication in this journal.
The authors grant Revista Enfermagem UERJ the right of first publication, to identify themselves as the original publisher of the work and grant the magazine a license of non-exclusive rights to use the work in the following ways:
- Sell and/or distribute the work in printed copies and/or electronic format;
- Distribute parts and/or the work as a whole with the aim of promoting the magazine through the internet and other digital and printed media;
- Record and playback work in any format, including digital media.
In line with the journal's policies, each published article will be assigned a Creative Commons Attribution (CC BY) license.
