| ObjectivesConduct an epidemiological survey to study breast-feeding outcomes of pregnant women who underwent labor analgesia and provide a theoretical basis for the safety of epidural analgesia during labor.Materials and MethodsA Questionnaire survey of 600 women who gave birth to a single live infant in Zhongda Hospital,in Nanjing,China between May 2016 and December 2016 was conducted.300 women receiving epidural analgesia during labor and 300 women not receiving epidural during labor were randomly selected in the ward.We excluded participants who subsequently did not meet the study eligibility criteria.210 healthy,fullterm,breastfeeding newborns delivered vaginally of mothers receiving epidural anesthesia were analyzed and compared with 199 newborns not exposed to maternal epidural anesthesia.Breastfeeding information was evaluated using a detailed questionnaire completed during the following two phases:i.)Early postpartum period(defined as the3rd day of delivery,usually on the day of discharge);ii)late postpartum period(defined as first 6 weeks postpartum).Statistical analysis:EPIDATA 3.1 and Statistical package for Social Scientists(SPSS)19.0 were used.Chi-Square test was used to assess the statistical significance of the association between two groups.Correlation coefficient was used to test the relationship between partial breastfeeding and factors relating breastfeeding cessation.A single logistic regression model was used to determine predictors of partial or no breastfeeding at hospital discharge.P value<0.05 was considered to be statistically significant.Results1.A total number of women using an epidural analgesia were 210(51.3%)out of 409 women.177(84.2%)number of women chose epidural analgesia due to fear from the labor pain.66%(n=140)of the women reported to be satisfied by the use of epidural and were willing to use epidural in future again if necessary.2.The epidural and non epidural groups were compared using chi square test concerning hospital support within 24 hours after delivery.Delay in holding the baby immediately after delivery showed statistical difference between the groups with p value<0.05.Similarly,help offered by staff in hospital in positioning and attaching baby for breastfeeding also showed significant difference between the groups with p value<0.05.51%(n=108)of the mothers who had laboured with epidural analgesia and 40%(n=81)of the mothers who laboured without epidural analgesia reported partial breast feeding or formula feeding at hospital discharge with p value<0.05.However,no significant difference in breastfeeding modalities was found at 6 weeks postpartum(P>0.05).Similarly,the problem of breastfeeding difficulty(83%,n=176)was more often complained by those who had had epidural with p value 0.010.3.Use of epidural,no skin to skin contact,delay in holding and initiating breastfeeding immediately after delivery were associated with the failure to breastfeed fully.A positive correlation between epidural use and partial breastfeeding(Spearman p=0.108 P=0,030)was noted.The logistic regression analysis showed that epidural analgesia during labor(Odd ratio,1.24;95%Confidence interval[CI],1.021-1.510)as one of the predictor of partial breastfeeding during hospital discharge(p<0.05).Conclusions1.Epidural analgesia provides women with excellent pain relief.2.Women in this study who chose or needed epidural analgesia were more likely to partially breastfeed their infant and more likely to experience breastfeeding difficulty during the hospital stay but not till 6 weeks postpartum.Use of epidural may extend the time to hold the baby immediately after birth.Therefore,women who are at higher risk of breastfeeding cessation should be provided with adequate breastfeeding assistance and support,both in the initial postpartum period and the following few months.3.Use of epidural,no skin to skin contact,delay in holding and initiating breastfeeding immediately after delivery were associated with the failure to breastfeed fully... |
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