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Submitted: 14 Aug 2025
Revision: 10 Oct 2025
Accepted: 18 Oct 2025
ePublished: 01 Dec 2025
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J Prev Epidemiol. Inpress.
doi: 10.34172/jpe.2025.39291
  Abstract View: 5

Original

Comparative analysis of umbilical cord arterial blood gas parameters in vaginal delivery with and without epidural analgesia; a prospective case-control study

Samaneh Saghafian Larijani 1 ORCID logo, Fatemeh Ashtari 2* ORCID logo, Seyed Yasin Amini 3 ORCID logo, Soheila Mahdavynia 4 ORCID logo, Shahla Mirgaloybayat 5 ORCID logo, Ashraf Mousavi 6 ORCID logo, Maryam Vafapour 6 ORCID logo, Melika Ansarin 7 ORCID logo

1 Department of Obstetrics and Gynecology, Firoozabadi Clinical Research Development Unit, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2 Department of Obstetric Anesthesiology, Firouzabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
3 Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
4 Department of Pediatric Nephrology, Firoozabadi Clinical Research Development Unit, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
5 Endometriosis Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
6 Department of Pediatrics, Firoozabadi Clinical Research Development Unit, Iran University of Medical Sciences, Tehran, Iran
7 Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
*Corresponding Author: Fatemeh Ashtari, Email: pa_md@yahoo.com

Abstract

Introduction: Epidural analgesia is a widely accepted and effective method for labor pain relief, though its impact on neonatal outcomes continues to be extensively studied. Key measures such as umbilical cord arterial blood gas (ABG) parameters, including pH and base excess (BE), provide valuable, objective indications of the newborn’s metabolic status immediately after birth.

Objectives: This study aimed to assess the physiological safety of epidural analgesia for both mother and neonate during vaginal delivery, thereby contributing to a clearer understanding of its clinical implications and neonatal well-being.

Patients and Methods: This prospective case-control study included 80 women referred to Firoozabadi hospital between September 2024 and August 2025, divided into two equal groups (n = 40) based on labor pain management: epidural analgesia and vaginal delivery without pain relief. All deliveries were conducted by a single gynecologist using a standardized protocol, and epidural analgesia was administered by a single anesthesiologist following a uniform method. Data collection involved obtaining informed consent, recording demographic and clinical data, assessing neonatal Apgar scores at birth, and measuring umbilical cord ABG parameters (pH and BE) immediately after delivery. All data were compared between the two groups using statistical tests.

Results: The results revealed no significant differences between the control and epidural analgesia groups in demographic characteristics such as age and body mass index (BMI), nor in clinical outcomes, including Apgar scores. Additionally, umbilical cord ABG parameters, specifically pH and BE values, were comparable between the groups, indicating no meaningful impact of epidural analgesia on maternal or neonatal acid-base status.

Conclusion: The results indicated that the epidural analgesia during vaginal delivery does not significantly impact maternal or neonatal acid-base status, and these findings confirm the safety of epidural analgesia as an effective pain relief method that does not compromise key physiological measures of metabolic health.


Citation: Saghafian Larijani S, Ashtari F, Amini SY, Mahdavynia S, Mirgaloybayat Sh, Mousavi A, Vafapour M, Ansarin M. Comparative analysis of umbilical cord arterial blood gas parameters in vaginal delivery with and without epidural analgesia; a prospective case-control study. J Prev Epidemiol. 2025;x(x):e39291. doi: 10.34172/jpe.2025.39291.
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