Low Apgar score, XXXX and epidural analgesia during labour: a Swedish registry-based study.

@entity1 @entity410 @entity75 @entity221 @entity1779
BACKGROUND: @entity221 ( @entity221 ) is associated with neonatal sequelae, and @entity1 in labour who receive epidural analgesia (EA) are more likely to develop @entity221 . The aims of this study were to investigate if EA and/or a diagnosis of @entity221 were associated to adverse neonatal outcomes at a population level. METHODS: Population-based register study with data from the Swedish Birth Register and the Swedish National @entity1 Register, including all nulliparae (n   =   294,329) with singleton pregnancies who gave birth at term in Sweden 1999-2008. Neonatal outcomes analysed were Apgar score (AS)   <   7 at 5   min and ICD-10 diagnosis of @entity75 (e.g. @entity410 or neonatal @entity1779 ). Multivariate logistic regression was used to calculate adjusted odds ratios (AOR) with 95% confidence intervals (CI). RESULTS: EA was used in 44% of the deliveries. Low AS or @entity75 was found in 1.26% and 0.39% of the @entity1 in the EA group compared with 0.80% and 0.29% in the control group. In multivariate analysis, EA was associated with increased risk with low AS, AOR 1.27 (95% CI 1.16-1.39), but not with diagnosis of @entity75 , 1.11 (0.96-1.29). A diagnosis of @entity221 was associated with increased risk for both low AS, 2.27 (1.71-3.02), and of @entity75 , 1.97 (1.19-3.26). CONCLUSION: Diagnosis of @entity221 was associated with low AS and @entity75 , whereas EA was only associated with low AS and not with @entity75 . The found associations might be a result of confounding by indication, which is difficult to assess in a registry-based population study.
