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Cited by 21Anesthesia and Pain ManagementMaternal and Perinatal Health InterventionsPain Management and Opioid Use

Neuraxial analgesia in labour and the foetus

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Kearns, R.J., Lucas, D.N.·2023·Best Practice & Research Clinical Anaesthesiology
DOI 10.1016/j.bpa.2023.02.005
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Abstract

Providing pain relief during labour is a fundamental human right and can benefit both mother and foetus. Epidural analgesia remains the 'gold standard', providing excellent pain relief, as well as the facility to convert to anaesthesia should operative intervention be required. While maternal well-being remains the primary focus, epidural analgesia may also have implications for the foetus. Data from meta-analyses finds that epidural compared with systemic opioids in labour is associated with reduced neonatal respiratory depression. Clinically relevant neonatal outcomes such as Apgar score <7 at 5 min, neonatal resuscitation and need for admission to a neonatal unit are reassuring, with the benefits of epidural analgesia for both mother and neonate outweighing any potential risks. Recent concerns regarding an association of epidural with the development of autism spectrum disorder in childhood appear to be unfounded, with several large observational studies refuting this association. This review discusses the evidence relating to maternal neuraxial analgesia in labour, implications for the foetus in utero, and childhood outcomes both in the immediate peripartum period and longer term.

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  • Neuraxial anesthesia, including epidural, spinal, and combined spinal-epidural techniques, is the standard of care or gold standard for labor analgesia and cesarean delivery.

    “Neuraxial anesthesia including epidural, spinal, and combined spinal–epidural techniques is the standard of care for labor analgesia and cesarean delivery”

    From Influence of Neuraxial Anesthesia Technique During Vaginal and Cesarean Delivery and Association with Postpartum Depression: A Narrative Review of Literature (2026) · cites this paper as [5]

    The Introduction (p. 1) calls epidural analgesia the “gold standard” for labour pain relief, and Neuraxial analgesia (p. 2) describes epidural and combined spinal–epidural techniques as commonly used, safe and effective. The paper says an epidural can be converted to anaesthesia for operative delivery (p. 3), but these passages do not establish standalone spinal anaesthesia or neuraxial techniques collectively as the standard of care for cesarean delivery. (LLM, conf=0.88)

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Cited by

Sorted by citations

Authors
Kearns, R. J., & Lucas, D. N.
Affiliations
  • University of Glasgow (GB)
  • London North West Healthcare NHS Trust (GB)
Corresponding author
Kearns, R.J.
ORCID
Venue
Best Practice & Research Clinical Anaesthesiology
Publisher
Elsevier BV
Published
2023-03
Volume
37
Issue
1
Pages
73-86
ISSN
  • 1521-6896 (ISSN-L)
  • 1753-3740
DOI
10.1016/j.bpa.2023.02.005
OpenAlex
W4323266835
Cited by
21
References
3
Citations by year
2026: 5 · 2025: 8 · 2024: 8
FWCI
1.28
Type
journal article
Language
en
Open access
Licence
Locations
  • Best practice & research. Clinical anaesthesiology (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
Funders
  • Chief Scientist Office
  • WellBeing of Women (RGS2301)
Topics
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
neuraxial analgesia, labor analgesia, epidural analgesia, neonatal outcomes, neonatal respiratory depression, systemic opioids, autism spectrum disorder, Apgar score, neonatal resuscitation, neonatal intensive care admission
MeSH terms
Autism Spectrum Disorder, Female, Fetus, Humans, Infant, Newborn, Pregnancy, Resuscitation, Analgesia, Epidural, Analgesia, Obstetrical, Labor Pain

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