Background
Some evidence indicates that maternal analgesia during labor may have adverse effects on neonates due to
exposure to specific drugs or the potential effects of analgesia on the course of labor. We assessed the
clinical outcome of term neonates born to mothers who received epidural analgesia (E) or systemic analgesia
with remifentanil (R) during labor.
Methods
Data was collected retrospectively over one year. We have evaluated the medical records of 247 full-term
neonates; 208 were born to mothers who received E and 39 to mothers who received R. Data on Apgar scores
and neonatal complications (perinatal asphyxia, respiratory distress, infection, hyperbilirubinemia, and
birth injuries), and average hospital stay were collected. Mann-Whitney U test, chi-square test, and logistic
regression analysis were used where appropriate.
Results
The values of the mean Apgar scores between E and R at 1 and 5 minutes were similar (8.83 vs. 8.97, p =
0.252; 9.81 vs. 9.87, p = 0.762, respectively). The average length of neonatal hospitalization did not differ
between groups (4.19 vs. 4; p = 0.557). The percentages of neonates with any complication were similar
between groups (28.3% vs. 32.5%, p = 0.598). Neonates born by cesarean delivery (CD) had significantly
worse outcomes than those born vaginally (p = 0.008, OR 2.8, 95% CI [1.30, 6.17]).
Conclusion
We did not find a statistically significant difference in mean Apgar scores and neonatal complications
between neonates who received epidural vs. remifentanil analgesia. An increased rate of complications in
neonates born via CD was found. Future studies should have a larger sample size and be powered to detect
associations in these findings.
