Effects of Water Immersion Versus Epidural as Analgesic Methods during Labor among Low-Risk Women: A 10-Year Retrospective Cohort Study.

Autor:	Herrero-Orenga C; Obstetrics and Gynecology Service, Maternal Ward Unit, Hospital of Inca, 07300 Inca, Spain.; Department of Nursing and Physiotherapy, University of Balearic Islands, 07122 Palma, Spain.; Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain., Galiana L; Department of Methodology for the Behavioral Sciences, University of Valencia, 46010 Valencia, Spain., Sansó N; Department of Nursing and Physiotherapy, University of Balearic Islands, 07122 Palma, Spain.; Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain., Martín MM; Obstetrics and Gynecology Service, Maternal Ward Unit, Hospital of Inca, 07300 Inca, Spain., Romero AC; Obstetrics and Gynecology Service, Maternal Ward Unit, Hospital of Inca, 07300 Inca, Spain., Fernández-Domínguez JC; Department of Nursing and Physiotherapy, University of Balearic Islands, 07122 Palma, Spain.; Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain.
Jazyk:	angličtina
Zdroj:	Healthcare (Basel, Switzerland) [Healthcare (Basel)] 2024 Sep 25; Vol. 12 (19). Date of Electronic Publication: 2024 Sep 25.
DOI:	10.3390/healthcare12191919
Abstrakt:	Background: Adequate pain relief during childbirth is a very important issue for women and healthcare providers. This study investigates the effects on maternal and neonatal outcomes of two analgesic methods during labor: water immersion and epidural analgesia. Methods: In this retrospective observational cohort study at a first-level hospital, in Spain, from 2009 to 2019, 1134 women, low-risk singleton and at term pregnancy, were selected. Among them, 567 women used water immersion; 567 women used epidural analgesia for pain control. Maternal outcomes included mode of birth and perineum condition. Neonatal outcomes included 5 min Apgar score, umbilical cord arterial pH, and Neonatal Intensive Care Unit admissions. Chi-square tests and Mann-Whitney U tests, together with their effect sizes (Cramer's V , odds ratio, and Cohen's d ) were used to test the main hypotheses. Results: Spontaneous vaginal birth was almost 17 times more likely in the water immersion group (OR = 16.866 [6.540, 43.480], p < 0.001), whereas the odds of having a cesarean birth were almost 40 times higher in the epidural group (OR = 39.346 [3.610, 429.120], p < 0.001). The odds of having an intact perineum were more than two times higher for the water immersion group (OR = 2.606 [1.290, 5.250], p = 0.007), whereas having an episiotomy was more than eight times more likely for the epidural group (OR = 8.307 [2.800, 24.610], p < 0.001). Newborns in the water immersion group showed a better 5 min Apgar score and umbilical cord arterial pH and lower rates in admissions at the Neonatal Intensive Care Unit. Conclusions: Women choosing water immersion as an analgesic method were no more likely to experience adverse outcomes and presented better results than women choosing epidural analgesia.
Databáze:	MEDLINE
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