[Frontiers in Bioscience E2, 1514-1519, June 1, 2010]

[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

1. Abstract
2. Introduction
3. Materials and methods: 3.1. Approval; 3.2. Patients; 3.3. Cortisol and endorphin assays; 3.4. Oxidative stress assay; 3.5. Cytokine assays; 3.6. Data analysis and statistical comparisons
4. Results
5. Discussion
6. Conclusions
7. Acknowledgment
8. References

1. ABSTRACT

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.