Open Access
Effects of epidural and systemic maternal analgesia in term infants: the NoPiL study
Carlo Dani1,Silvia Perugi1,Giulia Fontanelli1,Giovanna Bertini1,Simone Pratesi1,Giuseppe Buonocore1,Mariangela Longini1,Fabrizio Proietti1,Cosetta Felici1,Riccardo Ciuti1,Paola D'Onofrio1,Annamaria Melani Novelli1,Marco Pezzati1,Davide Gambi1,Gianfranco Scarselli1,Alessandro Frigiola1,Alessandro Giamberti1,Raul Abella1,Firmino F Rubaltelli1
Department of Surgical and Medical Critical Care, Section of Neonatology, University Hospital of Florence, Florence, Italy. cdani@unifi.It
DOI: 10.2741/E210 Volume 2 Issue 4, pp.1514-1519
Published: 01 June 2010
(This article belongs to the Special Issue Clinical and biochemical markers and fetal-neonatal development)

The aim of the No Pain in Labour (NoPiL) study was to evaluate the stress and clinical outcome of infants vaginally born without maternal analgesia and after maternal epidural or systemic analgesia. We studied 120 healthy term infants, 41 in the no analgesia group, 38 in the epidural analgesia group, and 41 in the systemic analgesia group. Cortisol, beta-endorphin, oxidative stress markers (ie: total hydroperoxide (TH) and advanced oxidation protein products (AOPP)), interleukin-1beta (IL-1beta), and interleukin-8 (IL-8) cytokines were measured in arterial cord blood samples. Infants in the 3 groups had similar Apgar score, cord blood pH and occurrence of hypoglycaemia, hyperbilirubinemia, and respiratory depression. Cortisol and endorphin plasma levels did not differ in the groups, nor did TH and AOPP values. IL-1beta and IL-8 cytokine were higher in infants born after maternal epidural analgesia than in other groups. Short-term outcome and stress were similar in infants vaginally born without maternal analgesia and after epidural and systemic analgesia. The possible implications of the highest interleukin levels in the epidural analgesia group deserve further study.

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Carlo Dani, Silvia Perugi, Giulia Fontanelli, Giovanna Bertini, Simone Pratesi, Giuseppe Buonocore, Mariangela Longini, Fabrizio Proietti, Cosetta Felici, Riccardo Ciuti, Paola D'Onofrio, Annamaria Melani Novelli, Marco Pezzati, Davide Gambi, Gianfranco Scarselli, Alessandro Frigiola, Alessandro Giamberti, Raul Abella, Firmino F Rubaltelli. Effects of epidural and systemic maternal analgesia in term infants: the NoPiL study. Frontiers in Bioscience-Elite. 2010. 2(4); 1514-1519.