The association between epidural labor analgesia and the fetal outcome and mode of delivery of the second twin: a nationwide register-based cohort study in Finland.

Int J Obstet Anesth

Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland; Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.

Published: November 2023

Background: The aim of this study was to assess the association between epidural labor analgesia and the mode of delivery for the second twin and to analyze the health outcomes of the second twin.

Methods: In this nationwide, retrospective, register-based cohort study, data from the National Medical Birth Register (MBR) of Finland (2004-2018) were used to analyze the association between epidural analgesia and delivery mode (emergency and urgent cesarean section, and assisted vaginal delivery) and fetal outcomes (neonatal mortality and need for intensive care unit admission) for the second twin. Multivariable logistic regression was used to assess the delivery mode and fetal outcomes of the second twin.

Results: A total of 3242 twin pregnancies with epidural analgesia were compared with a control group consisting of 2780 twin pregnancies without epidural analgesia. Epidural analgesia was associated with lower odds for all cesarean delivery (aOR 0.64, 95% CI 0.44 to 0.92) for the second twin and for emergency cesarean delivery (aOR 0.52, 95% CI 0.33 to 0.79) when compared with the odds for the second twin in the control group. Epidural analgesia was associated with lower odds of neonatal mortality for the second twin (aOR 0.61, 95% CI 0.73 to 0.90).

Conclusion: This study found epidural labor analgesia was associated with a lower rate of emergency cesarean delivery and neonatal mortality for the second twin. These results should be acknowledged by obstetricians and anesthesiologists when planning optimal peripartum management for mothers with twin pregnancies.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijoa.2023.103924DOI Listing

Publication Analysis

Top Keywords

second twin
28
epidural analgesia
20
association epidural
12
epidural labor
12
labor analgesia
12
neonatal mortality
12
twin pregnancies
12
analgesia associated
12
associated lower
12
cesarean delivery
12

Similar Publications

Selective Fetal Growth Restriction Leading to Cerebral Injury in Monochorionic Twins: A Case Report.

Cureus

December 2024

Neonatology Department, Daniel de Matos Maternity, Coimbra Local Health Unit, Coimbra, PRT.

Monochorionic twin pregnancies carry a risk of perinatal complications due to shared placental anastomoses, which can cause uneven blood distribution and lead to conditions like selective fetal growth restriction (sFGR). This case describes a monochorionic pregnancy complicated by preeclampsia and late-onset sFGR of twin B. Labor was prematurely induced and a 45% weight discordance between the twins was confirmed.

View Article and Find Full Text PDF

Biomarkers of ageing (BA) can predict health risks beyond chronological age, but little is known about how marital/living status affects longitudinal changes in BA. We examined the association between marital/living status and BA over time using the-Swedish-Adoption/Twin-Study-of-Aging (SATSA) cohort. Four BAs were analyzed: telomere length (TL) (638 individuals; 1603 measurements), DNAmAge (535 individuals; 1392 measurements), cognition (823 individuals; 3218 measurements), and frailty index (FI) (1828 individuals; 9502 measurements).

View Article and Find Full Text PDF

Rhein: An Updated Review Concerning Its Biological Activity, Pharmacokinetics, Structure Optimization, and Future Pharmaceutical Applications.

Pharmaceuticals (Basel)

December 2024

State Key Laboratory of Integration and Innovation of Classic Formula and Modern Chinese Medicine, National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China.

Rhein is a natural active ingredient in traditional Chinese medicine that has attracted much attention due to its wide range of pharmacological activities. However, its clinical application is limited by low water solubility, poor oral absorption, and potential toxicity to the liver and kidneys. Recently, advanced extraction and synthesis techniques have made it possible to develop derivatives of rhein, which have better pharmacological properties and lower toxicity.

View Article and Find Full Text PDF

The human gastrointestinal microbiota plays a vital role in maintaining host health and preventing diseases, prompting the creation of simulators to replicate this intricate system. The Simulator of the Human Intestinal Microbial Ecosystem (SHIME), a multicompartment dynamic simulator, has emerged as a pivotal in vitro model for studying the interactions and interferences within the human gut microbiota. The continuous and real-time monitoring hallmarks, along with the programmatically flexible setup, bestow SHIME with the ability to mimic the entire human intestinal ecosystem with high dynamics and stability, allowing the evaluation of various treatments on the bowel microbiota in a controlled environment.

View Article and Find Full Text PDF

DNA methylation age (DNAmAge) surpasses chronological age in its ability to predict age-related morbidities and mortality. This study analyzed data from 287 middle-aged twins in the Louisville Twin Study (mean age 51.9 years ± 7.

View Article and Find Full Text PDF

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!