Epidural labor analgesia may lower rate of emergency cesarean and neonatal mortality for the second twin

This study entitled “ The association between epidural labor analgesia and the fetal outcome and mode of delivery of the second twin: a nationwide register-based cohort study in Finland is led by M Vaajala et al. and colleagues and is published in the International Journal of Obstetric Anesthesia.”

Researchers used data from nationwide, retrospective, register-based cohort studies and data from Finland's National Medical Birth Register (MBR) (2004-2018).

The key results of the study are:

A total of 3242 twin pregnancies with epidural analgesia were compared with a control group of 2780 twin pregnancies without epidural analgesia.

Epidural analgesia was associated with lower odds for all cesarean deliveries, with aOR of 0.64 for the second twin and emergency cesarean delivery, with aOR of 0.52 compared with the odds for the second twin in the control group.

Epidural analgesia was associated with lower odds of neonatal mortality for the second twin with aOR 0.61.

In conclusion, the researchers stated that there is a correlation between epidural labor analgesia and a lower rate of emergency cesarean delivery and neonatal mortality for the second twin. They emphasized that these findings should be taken into consideration by obstetricians and anesthesiologists when devising optimal peripartum management for mothers with twin pregnancies.

Further reading:

https://pubmed.ncbi.nlm.nih.gov/37657128/