Effect of epidural labor analgesia on maternal and infant outcomes in parturients with gestational diabetes mellitus-A prospective cohort study

Gehui Li; Xiaofei Qi; Xuhong Tan; Mingguang Wu; Hao Wang; Ping Wen; Xiaolei Huang; Yuantao Li

doi:10.3389/fped.2022.1022291

Effect of epidural labor analgesia on maternal and infant outcomes in parturients with gestational diabetes mellitus-A prospective cohort study

Front Pediatr. 2022 Dec 12:10:1022291. doi: 10.3389/fped.2022.1022291. eCollection 2022.

Authors

Gehui Li¹, Xiaofei Qi¹, Xuhong Tan¹, Mingguang Wu¹, Hao Wang², Ping Wen³, Xiaolei Huang¹, Yuantao Li¹

Affiliations

¹ Department of Anesthesiology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.
² Department of Food Safety, Market Supervision Administration of Shenzhen Municipality, Shenzhen, China.
³ Department of Science and Education, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.

Abstract

Background: The occurrence of gestational diabetes mellitus (GDM) is caused by a variety of factors and associated with increased risks of several adverse outcomes for both mothers and infants. However, the effects of epidural labor analgesia in parturients with GDM on maternal and infant outcomes have not been characterized.

Methods: According to parturients' choice, they were divided into the epidural group (n = 133) and no epidural (control) group (n = 135). Data for relative variables in the perinatal period were collected, and the potential associations of epidural labor analgesia with infant outcomes were analyzed by univariate analysis and multivariate logistic regression analyses.

Results: The rate of neonatal admission to the neonatal intensive care unit (NICU) for hypoglycemia was higher in the epidural group (7.52%) than in the control group (1.48%; P < 0.05). Epidural labor analgesia and drug-based diabetes control were independent predictors of the rate of neonate transfer to the NICU for hypoglycemia.

Conclusion: Epidural labor analgesia was associated with an increased risk of neonatal transfer to the NICU for hypoglycemia. Thus, monitoring of neonatal blood glucose levels after administration of epidural labor analgesia in parturients with GDM may be beneficial.Trial registration: The study was registered in the China Clinical Registration Center (Registration No. ChiCTR-OOC-17013164, Registered on 30 October 2017).

Keywords: epidural labor analgesia; gestational diabetes mellitus (GDM); infant outcomes; maternal outcomes; neonatal hypoglycemia.