RT info:eu-repo/semantics/article T1 Epidural analgesia and its implications in the maternal health in a low parity comunity A1 Peñuela Saldaña, Iván Stanley A1 Isasi Nebreda, Pilar A1 Almeida, Hedylamar A1 Lorenzo López, Mario A1 Gómez Sánchez, Esther A1 Tamayo Gómez, Eduardo K1 Epidural analgesia K1 Analgesia epidural K1 Perineal tear K1 Desgarro perineal K1 Caesarean section K1 Cesárea AB Background: In regard to obstetrical analgesia management there are different results related to the use of epidural analgesia versus mechanical adverse outcomes at delivery. Methods: Cohort study of 23,183 consecutive, term, singleton vaginal deliveries, including spontaneous and induced labours, at a single institution from January 2004 to June 2016 to determine the association between epidural analgesia and different mechanical complications affecting maternal health such as severe perineal tears (SPT), abnormal foetal head position at delivery, instrumental delivery and caesarean section (CS). Multivariate logistic regression models were constructed to evaluate the risk factors of these mechanical complications with respect to possible cofounders. Results: Epidural analgesia was used in 15,821 (68.24%) women. The logistic regression model showed a non-significant association between the use of epidural analgesia and SPT (odds ratio [OR], 078; 95% confidence interval [CI], 0.48–1.26; p = 0.310). Instrumental delivery and CSs were more frequently performed in cases than controls (p = < 0.001), with OR of 1.19 (95% CI: 1.10–1.29) for CS and with OR of 3.27 (95% CI: 2.93–4.61) for instrumental delivery. The abnormal foetal position head at delivery were significantly lower in the neonates delivered without epidural analgesia compared with those in which epidural analgesia was used (p < 0.001) with OR of 1.43 (95% CI:1.27–1.72). Conclusions: Epidural analgesia is not associated with an increase of SPT, but it was an independent risk factor for instrumental delivery, CS and abnormal foetal head position at delivery. PB BioMed Central SN 1471-2393 YR 2019 FD 2019 LK http://uvadoc.uva.es/handle/10324/45474 UL http://uvadoc.uva.es/handle/10324/45474 LA eng NO BMC Pregnancy and Childbirth, 2019, vol. 19. 9 p. NO Producción Científica DS UVaDOC RD 11-dic-2024