Association of Labor Neuraxial Analgesia with Maternal Blood Transfusion

ConclusionsLabor neuraxial analgesia may be associated with reduced odds of maternal blood transfusion in intrapartum cesarean deliveries and, to a lesser extent, vaginal deliveries. The specific effect size varies widely by delivery mode and is unclear given the poor sensitivity of the data set for the maternal transfusion primary outcome.Editor ’s PerspectiveWhat We Already Know about This TopicLabor neuraxial analgesia may reduce the risk of postpartum hemorrhageIt is unclear whether labor neuraxial analgesia is associated with a lower risk of maternal transfusion compared to delivery without neuraxial analgesiaWhat This Article Tells Us That Is NewUsing propensity score matching, U.S. birth certificate data for 12,503,042 patients from 2015 to 2018 demonstrated an adjusted maternal transfusion incidence of 30.5 per 10,000 for patients without labor neuraxial analgesiaversus 20.2 per 10,000 for patients with labor neuraxial analgesia, a 13% reduction (95% CI, 18% to 9%)This estimated reduction in maternal transfusion varied by delivery modePatients undergoing vaginal deliveries with labor neuraxial analgesia demonstrated a small 7% adjusted reduction (95% CI, 12% to 2%) in maternal transfusionPatients undergoing intrapartum cesarean deliveries (after a trial of labor) with labor neuraxial analgesia demonstrated a 45% adjusted reduction (95% CI, 52% to 36%) in maternal transfusion

Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research