[Frontiers in Bioscience E2, 1514-1519, June 1, 2010]
Effects of epidural and systemic maternal analgesia in term infants: the NoPiL study
Carlo Dani1, Silvia Perugi1, Giulia Fontanelli1, Giovanna Bertini1, Simone Pratesi1, Giuseppe Buonocore2, Mariangela Longini2, Fabrizio Proietti2, Cosetta Felici2, Riccardo Ciuti3, Paola D'Onofrio4, Annamaria Melani Novelli4, Marco Pezzati5, Davide Gambi6, Gianfranco Scarselli7, Alessandro Frigiola8, Alessandro Giamberti8, Raul Abella8, Firmino F. Rubaltelli1
1Department of Surgical and Medical Critical Care, Section of Neonatology, University Hospital of Florence, Florence, Italy, 2Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, 3Central Laboratory of Chemical-Clinical Analysis, Careggi University Hospital of Florence, Division of Anesthesiology, 4Careggi University Hospital of Florence, Italy, 5Division of Neonatology, "S. Giovanni di Dio" Hospital of Florence, Italy, 6Division of Anesthesiology, "S. Giovanni di Dio" Hospital of Florence, Italy, 7Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy, Research Laboratory, 8Department of Cardiac Surgery, IRCCS San Donato Milanese, Italy
TABLE OF CONTENTS
The aim of the No Pain in Labour (NoPiL) study was 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, ß-endorphin, oxidative stress markers (ie: total hydroperoxide (TH) and advanced oxidation protein products (AOPP)), interleukin-1β (IL-1β), 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-1β 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.