Background: Identify variables associated with intrapartum epidural use.
Methods: Odds ratios were calculated to quantify associations between selected variables and epidural use using a population-based case-control study of Washington State birth certificate data from 2009.
Results: Non-Whites had 10 - 45% lower odds of epidural use relative to Whites. Foreign-born women had 25 - 45% lower odds of epidural use compared to their US-born counterparts, except for Asians. Women who smoked or induced labor had higher roughly 2-fold higher odds of epidural use compared with non-smokers or women giving birth spontaneously, respectively. Women without a high school diploma or equivalent had lower odds of epidural use relative to those who graduated. Delivering at perinatal units, rural hospitals, or non-profit hospitals had ~50% lower odds of epidural use compared with secondary/teritiary perinatal units, urban hospitals or for-profit hospitals, respectively.
Conclusion: Several individual and health service-related variables were associated with epidural use. These findings elucidate the clinical relevance of epidural use, and dispariaties in its utilization and in quality of care during delivery.
Keywords: Epidural use; Foreign birth; Labor; Racial disparities.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3320121 | PMC |
| http://dx.doi.org/10.4021/jocmr810w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association of epidural labor analgesia with maternal and neonatal outcomes in women with preeclampsia: a propensity score-matched single-center retrospective cohort study.
BMC Pregnancy Childbirth
January 2025
Department of Anesthesiology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Medical University, Fujian, Fuzhou 350001, China.
Background: Epidural labor analgesia (ELA) is widely and safely used for labor pain relief. However, it remains unclear whether ELA affects maternal and neonatal outcomes in women suffering from preeclampsia.
Methods: This study reviewed the medical records of women with preeclampsia at ≥ 28 weeks of gestation between January 2015 and December 2020.
Investigating disparity in labor epidural analgesia management in black vs. white women: a retrospective case-control study (2018-2022).
Int J Obstet Anesth
January 2025
Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA.
Background: Disparities in labor epidural analgesia (LEA) management could reduce maternal satisfaction and increase risk. We compared times from the first administration of breakthrough pain medication (top-up) to LEA replacement to evaluate disparities across race.
Methods: In this retrospective cohort study (01-01-2018 to 12-31-2022), all patients with LEA and maternal race/ethnicity of non-Hispanic White or Black were eligible.
A Quasi-experimental Study of Optimized Retractor Management on the Incidence of Femoral Nerve Injury Following Gynecological Surgery.
Cureus
December 2024
Anesthesiology, Jikei University School of Medicine, Tokyo, JPN.
Background Femoral neuropathy is a significant postoperative complication in gynecological surgery that can severely impact patient mobility and quality of life. Among various mechanisms of nerve injury, retractor-induced compression against the pelvic sidewall has been identified as a particularly crucial causative factor. Despite this well-recognized mechanism and its clinical importance, few studies have investigated specific preventive strategies for this iatrogenic complication.
View Article and Find Full Text PDFUtilization and Outcomes of Epidural Anesthesia Versus Regional Anesthesia for Thoracic Surgery: An ACS-NSQIP Analysis.
J Cardiothorac Vasc Anesth
December 2024
Departments Anesthesiology, Uniformed Services University, Bethesda, MD.
Objectives: To determine the use of epidural anesthesia compared with regional anesthesia as an adjunct to general anesthesia in thoracic surgery over time, and compare length of stay, overall morbidity, serious morbidity, and mortality between epidural and regional anesthesia when utilized as adjuncts to general anesthesia in thoracic surgery.
Design: Retrospective data analysis from the American College of Surgeons National Surgical Quality Improvement Project data registry, years 2014 to 2022.
Setting: Over 800 U.
Improving Thoracic Trauma Care: Locoregional Analgesia in the Intensive Care Unit.
Cureus
December 2024
Intensive Care Unit, Unidade Local Saúde Viseu Dão-Lafões, Viseu, PRT.
Article Synopsis
- Pain management for thoracic trauma patients traditionally relies on opioids, which can have significant side effects; locoregional anesthesia/analgesia (LRAA) offers a targeted alternative.
- The study analyzed 43 LRAA procedures in 33 ICU patients and found that 50% who received LRAA avoided intubation, leading to shorter ICU stays (9 vs. 13 days) and no severe complications from the LRAA techniques.
- Results indicate that early use of LRAA can enhance clinical outcomes for thoracic trauma patients, highlighting its potential but also the need for further investigation to understand its full benefits.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!