Abstract
Objective:
To investigate the association between pharmacological analgesia and childbirth outcomes.
Methods:
A cross-sectional study using a representative sample of childbirth performed in 2013, at a maternity hospital in Belo Horizonte, Minas Gerais. Data from 978 childbirths were included, excluding elective cesareans. The main exposure was the use of pharmacological analgesia during labor, with the outcome classified as vaginal, instrumental vaginal, or cesarean delivery. The association between analgesia and childbirth outcomes was assessed using multinomial logistic regression to obtain Odds Ratio (OR) estimates with their respective 95% confidence intervals. The final model was adjusted for the woman's age, number of previous births, presence of companion or doula, and cervical dilatation at the time of analgesia.
Results:
Among the total number of births, 87.1% were vaginal and 12.9% were cesarean. The prevalence of the use of pharmacological analgesia was 34.2%, and delivery with instrumentation was 8.4%. About 70% of the women had a normal risk pregnancy. Even after adjusting for confounding variables, the use of analgesia increased the chance of delivery with instrumentation by 3.5 times (p<0.0001); for women with high-risk pregnancies, this increase was even higher (OR=4.62; p<0.0001). There was no association between analgesia and cesarean section (p=0.320).
Conclusion:
The use of pharmacological analgesia modifies the outcome of childbirth, increasing the chances of delivery with instrumentation, especially in women with high-risk pregnancies. In this context, it is important to guide women about the potential risks and benefits of analgesia so they may make a safe choice.
Keywords
Labor pain; Analgesia; obstetrical; Labor; obstetric; Extraction; obstetrica