{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:06:25Z","timestamp":1785434785003,"version":"3.56.0"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,7,18]],"date-time":"2014-07-18T00:00:00Z","timestamp":1405641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ochrane <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>ystematic <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>eview of randomised controlled trials of epidural analgesia compared with other or no analgesia in labour reported no overall increased risk of caesarean delivery. However, many trials were affected by substantial non\u2010compliance, and there are concerns about the external validity of some trials for contemporary maternity populations. We aimed to explore the association between epidural analgesia in labour and caesarean delivery in clinical practice and compare with findings from randomised controlled trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Population\u2010based cohort of pregnant women (<jats:italic>n<\/jats:italic>\u2009=\u2009210\u2009708) without major obstetrical complications who delivered a singleton live infant in hospitals in <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ew <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>outh <jats:styled-content style=\"fixed-case\">W<\/jats:styled-content>ales, <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ustralia, 2007\u201310. Data were obtained from linked, validated population\u2010based data collections. Propensity score matching was used to examine the association between epidural analgesia in labour and caesarean delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Epidural analgesia in labour was used by a third (31.5%, <jats:italic>n<\/jats:italic>\u2009=\u200966\u2009317) of the women, and 9.8% (<jats:italic>n<\/jats:italic>\u2009=\u200920\u2009531) had a caesarean delivery. Epidural analgesia in labour was associated with increased risk of caesarean delivery {risk ratio [<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>] 2.5, [95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 2.5, 2.6]}. The association with epidural analgesia in labour was higher for caesarean delivery for failure to progress {<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 3.0, [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.9, 3.0]} than for caesarean delivery for fetal distress {<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.9, [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.8, 2.0]}.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Epidural analgesia in labour is associated with caesarean delivery in a large maternity population. Population\u2010based studies contribute important data about obstetrical care, when research settings and participants may not represent the clinical settings or broader population in which obstetrical interventions in labour are applied.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12139","type":"journal-article","created":{"date-parts":[[2014,7,18]],"date-time":"2014-07-18T11:45:59Z","timestamp":1405683959000},"page":"400-411","source":"Crossref","is-referenced-by-count":27,"title":["Epidural Analgesia in Labour and Risk of Caesarean Delivery"],"prefix":"10.1111","volume":"28","author":[{"given":"Melanie","family":"Bannister\u2010Tyrrell","sequence":"first","affiliation":[{"name":"Kolling Institute of Medical Research University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane B.","family":"Ford","sequence":"additional","affiliation":[{"name":"Kolling Institute of Medical Research University of Sydney  Sydney 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