Outcome of Deliveries Following Labour Epidural Analgesia in a Malaysian Teaching Hospital

Effects of labour epidural analgesia (LEA) on mode of delivery is unclear. We aimed to establish if LEA was associated with increased rate of caesarean delivery (CD) or vaginal assisted delivery (VAD). This retrospective cohort study analysed the birth and LEA records consecutively from January until April 2021. Elective CDs were excluded. Paturients were divided into LEA and non-labour epidural analgesia (NLEA) groups. Outcomes measured were mode of deliveries stated as CD, VAD or spontaneous vaginal delivery (SVD). A total of 262 deliveries met the inclusion criteria. Spontaneous vaginal deliveries were significantly observed more in NLEA group (LEA 2(1.5%) vs NLEA 79(60.3%), p<0.001) whereas LEA group had significantly more VADs and CDs (LEA VAD 60(45.8%) vs NLEA VAD 4(3.1%), p<0.001; LEA CD 69(52.7%) vs NLEA CD 48(36.6%), p=0.013 respectively). The risk factors associated with CD were analysed using logistic regression (LR) models. Univariate showed that LEA and parity 0 was associated with increased risk for CD while multivariate analysis showed LEA was an independent risk factor for CD.  Parturient in LEA group had almost twice the risk to have CDs [adjusted odds ratio 1.973(1.116-3.486), p=0.019]. In conclusion, LEA is associated with increased rate of CDs and VADs.