Use of epidural anesthesia and the risk of acute postpartum urinary retention

Objective We aimed to examine the relationship between the use of epidural analgesia during labor and acute postpartum urinary retention. Study Design A retrospective cohort study was conducted using 1994 labor and postpartum health records from 3 primary care centers. Results Logistic regression an...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2007-05, Vol.196 (5), p.472.e1-472.e5
Main Authors: Musselwhite, Kimberly L., RN, MN, Faris, Peter, PhD, Moore, Katherine, RN, PhD, Berci, Dena, RN, MN, King, Kathryn M., RN, PhD
Format: Article
Language:English
Subjects:
Acute Disease
acute postpartum urinary retention
Adult
Analgesia, Epidural - adverse effects
Analgesia, Obstetrical - adverse effects
Cohort Studies
epidural analgesia
Female
Humans
Obstetrics and Gynecology
Postpartum Period
Pregnancy
Puerperal Disorders - etiology
Retrospective Studies
Risk
Urinary Retention - etiology
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Summary:Objective We aimed to examine the relationship between the use of epidural analgesia during labor and acute postpartum urinary retention. Study Design A retrospective cohort study was conducted using 1994 labor and postpartum health records from 3 primary care centers. Results Logistic regression analysis revealed that a longer second stage of labor (odds ratio [OR] 2.62; 95% confidence interval [CI] 1.41-4.85), use of systemic narcotics (OR 1.63; 95% CI 1.04-2.57), perineal laceration (OR 1.73; 95% CI 1.02-2.91), and instrumental delivery (OR 1.86; 95% CI 1.16-2.97) predicted urinary retention. There was a trend toward association of epidural analgesia and urinary retention (OR 1.69; 95% CI 0.98-2.92). Propensity score analysis revealed that any effect of epidural analgesia was likely due to effect modification of other obstetric variables. Conclusion Epidural analgesia during labor may increase the risk of developing urinary retention by up to 3 times. However, this effect is mediated by other obstetric variables.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2006.11.031