{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T14:18:51Z","timestamp":1784211531882,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012505","name":"Royal Perth Hospital Medical Research Foundation","doi-asserted-by":"publisher","award":["MC_UU_00011\/1\u20106"],"award-info":[{"award-number":["MC_UU_00011\/1\u20106"]}],"id":[{"id":"10.13039\/100012505","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000325","name":"Wellbeing of Women","doi-asserted-by":"publisher","award":["rgs2301"],"award-info":[{"award-number":["rgs2301"]}],"id":[{"id":"10.13039\/501100000325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000883","name":"University of Bristol","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000883","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Socio\u2010economic deprivation is associated with adverse maternal and childhood outcomes. Epidural analgesia, the gold standard for labour analgesia, may improve maternal well\u2010being. We assessed the association of socio\u2010economic status with utilisation of epidural analgesia and whether this differed when epidural analgesia was advisable for maternal safety. This was a population\u2010based study of NHS data for all women in labour in Scotland between 1 January 2007 and 23 October 2020, excluding elective caesarean sections. Socio\u2010economic status deciles were defined using the Scottish Index of Multiple Deprivation. Medical conditions for which epidural analgesia is advisable for maternal safety (medical indications) and contraindications were defined according to national guidelines. Of 593,230 patients in labour, 131,521 (22.2%) received epidural analgesia. Those from the most deprived areas were 16% less likely to receive epidural analgesia than the most affluent (relative risk 0.84 [95%CI 0.82\u20130.85]), with the inter\u2010decile mean change in receiving epidural analgesia estimated at \u20102% ([95%CI \u20102.2% to \u20101.7%]). Among the 21,219 deliveries with a documented medical indication for epidural analgesia, the socio\u2010economic gradient persisted (relative risk 0.79 [95%CI 0.75\u20130.84], inter\u2010decile mean change in receiving epidural analgesia \u20102.5% [95%CI \u20103.1% to \u20102.0%]). Women in the most deprived areas with a medical indication for epidural analgesia were still less likely (absolute risk 0.23 [95%CI 0.22\u20130.24]) to receive epidural analgesia than women from the most advantaged decile without a medical indication (absolute risk 0.25 [95%CI 0.24\u20130.25]). Socio\u2010economic deprivation is associated with lower utilisation of epidural analgesia, even when epidural analgesia is advisable for maternal safety. Ensuring equitable access to an intervention that alleviates pain and potentially reduces adverse outcomes is crucial.<\/jats:p>","DOI":"10.1111\/anae.16236","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T18:01:56Z","timestamp":1708020116000},"page":"473-485","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Socio\u2010economic disadvantage and utilisation of labour epidural analgesia in Scotland: a population\u2010based study\n                    <sup>\u2020<\/sup>"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0468-7941","authenticated-orcid":false,"given":"L.","family":"Halliday","sequence":"first","affiliation":[{"name":"School of Medicine, Dentistry and Nursing University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Medical Physics NHS Greater Glasgow and Clyde  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kyzayeva","sequence":"additional","affiliation":[{"name":"School of Medicine, Dentistry and Nursing University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6793-2262","authenticated-orcid":false,"given":"D. A.","family":"Lawlor","sequence":"additional","affiliation":[{"name":"MRC Integrative Epidemiology Unit at the University of Bristol  Bristol UK"},{"name":"Population Health Sciences University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9099-3047","authenticated-orcid":false,"given":"S. M.","family":"Nelson","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Bristol Biomedical Research Centre University Hospitals Bristol NHS Foundation Trust and University of Bristol  Bristol UK"},{"name":"School of Medicine, Dentistry and Nursing University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6156-6858","authenticated-orcid":false,"given":"R. J.","family":"Kearns","sequence":"additional","affiliation":[{"name":"School of Medicine, Dentistry and Nursing University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organization.WHO recommendations: intrapartum care for a positive childbirth experience. 2018.https:\/\/www.who.int\/publications\/i\/item\/9789241550215(accessed 08\/12\/2023)."},{"key":"e_1_2_6_3_1","article-title":"Epidural versus non\u2010epidural or no analgesia for pain management in labour","volume":"5","author":"Anim\u2010Somuah MSR","year":"2018","journal-title":"Cochrane Database of Systematic 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