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Obstetrical outcomes of labor with and without analgesia in Robson classification groups 1 and 2a: a single-center retrospective study

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Abstract

Purpose

This study aimed to elucidate the effects of neuraxial analgesia on labor in women classified based on the Robson classification system.

Methods

We retrospectively reviewed the clinical data of singleton cephalic nulliparous deliveries in labor at term between January 2018 and December 2021 and compared obstetrical outcomes between deliveries with and without neuraxial analgesia in women of Robson group 1 (spontaneous labor) and group 2a (induced labor). Statistical analyses were performed using the Wilcoxon ranked-sum test, Fisher’s exact test, and logistic regression model. Statistical significance was set at p < 0.05.

Results

We identified 2726 deliveries during the period, of which 387 deliveries (215 with analgesia and 172 without analgesia) were in Robson group 1 and 502 deliveries (258 with analgesia and 244 without analgesia) in Robson 2a. In Robson group 1 pregnancies, the cesarean section (CS) rate was higher in those who received analgesia (15%) than in those who did not (3%) (p = 0.0001). Multivariate analysis revealed that labor with analgesia was a significant risk factor for CS (p < 0.0001). Similarly, in Robson group 2a pregnancies, we observed a higher CS rate in those with analgesia than in those without analgesia (18 vs. 11%, p = 0.042).

Conclusion

A higher CS rate was observed in deliveries with analgesia than in those without analgesia both in the Robson group 1 and group 2a pregnancies.

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Acknowledgements

We would like to thank Yoko Kawanishi, Kosuke Hiramatsu, Mahiru Kawano, Aiko Kakigano, and Toshihiro Kimura for their assistance and clinical support at Osaka University Hospital.

Funding

None.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-Oka, Clinical Research Building 3rd Floor, Suita City, Osaka, 565-0871, Japan

    Taro Yagi, Yasuto Kinose, Michiko Bun, Megumi Horai, Tatsuya Miyake, Kazuya Mimura, Masayuki Endo & Tadashi Kimura

  2. Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan

    Chie Matsuda & Chiyo Otaki

  3. Department of Children and Women’s Health, Division of Health Science, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan

    Masayuki Endo

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  1. Taro Yagi
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  2. Yasuto Kinose
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  4. Megumi Horai
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Corresponding author

Correspondence to Yasuto Kinose.

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Ethical approval

The study was approved by the ethics committee of Osaka University Hospital, Japan (registration number: 21517).

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Informed consent was obtained from all patients using an opt-out approach on the hospital website.

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540_2022_3125_MOESM1_ESM.tif

Figure S1: Schematic diagram of the Robson classification. The shaded area indicates groups 1 and 2a. CS, cesarean section. Supplementary file1 (TIF 127 kb)

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Yagi, T., Kinose, Y., Bun, M. et al. Obstetrical outcomes of labor with and without analgesia in Robson classification groups 1 and 2a: a single-center retrospective study. J Anesth 37, 39–48 (2023). https://doi.org/10.1007/s00540-022-03125-9

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  • DOI: https://doi.org/10.1007/s00540-022-03125-9

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