Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT

Bidragets oversatte titel: Kan fødselsforberedelse i mindre hold reducere brug af epiduralblokade under fødslen - et dansk randomiseret studie

Carina Sjöberg Brixval, Lau Caspar Thygesen, Solveig Forberg Axelsen, Pernille Due, Vibeke Koushede

Publikation: Konferencebidrag uden forlag/tidsskriftKonferenceabstrakt til konferenceForskningpeer review

Resumé

Background: Epidural analgesia is widely used as pain relief during labour but has negative side effects, such as prolonged labour and increased risk of obstetric interventions. Antenatal education in small groups may increase trust in own ability to cope at home in the early stages of labour, and reduce fear during birth which in turn may decrease use of pain relief. Few randomised trials have examined the effect of attending antenatal education in small groups on use of epidural analgesia and among these conclusions are conflicting. The objective of this study was therefore to examine the effect of an antenatal education program in small classes on use of epidural analgesia.
Methods: Data from the NEWBORN trial were used. A total of 1766 women from the Copenhagen area, Denmark were randomized to participate in either antenatal education in small groups or standard care. Data were analysed according to the ‘intention-to-treat’ principle. Frequency of use of epidural analgesia was compared between intervention groups using the chi-square test. Unadjusted logistic regression analysis as well as analyses adjusted for the protocol specified stratification variables: parity and vulnerability were carried out.
Results: At the time of writing the participants’ intervention category is blinded to the researchers and therefore results are presented blinded in this abstract. The blinding will be revealed within the next month and unblinded results can be presented at the conference. Frequency of epidural analgesia was 30.9 % in intervention category X and 29.1 % in intervention category Y (χ2 = 0.67, p=0.41).
Conclusion: No differences in frequency of use of epidural analgesia were seen between intervention groups. Hence, the NEWBORN program had no effect on use of epidural analgesia in this trial. Recommendations on whether to implement the NEWBORN program in a clinical setting also depend upon the trial effect on psycho-social outcomes which will be analysed in near future.

Main messages (max 200 anslag):
1. No effect of antenatal education in small groups on use of epidural analgesia as pain relief during labour is seen in this Danish randomized trial
2. Recommendations on whether to implement the NEWBORN program in a clinical setting requires further research on effect on other outcomes relevant to birth and parenthood.
OriginalsprogEngelsk
Publikationsdato1. jul. 2015
Antal sider1
StatusUdgivet - 1. jul. 2015
Begivenhed8th European Public Health Conference: Health in Europe – from global to local policies, methods and practices - MIlano, Italien
Varighed: 14. okt. 201517. okt. 2015

Konference

Konference8th European Public Health Conference
LandItalien
ByMIlano
Periode14/10/201517/10/2015

Emneord

  • Antenatal education
  • Epidural analgesia

Citer dette

Brixval, C. S., Thygesen, L. C., Axelsen, S. F., Due, P., & Koushede, V. (2015). Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT. Abstract fra 8th European Public Health Conference, MIlano, Italien.
Brixval, Carina Sjöberg ; Thygesen, Lau Caspar ; Axelsen, Solveig Forberg ; Due, Pernille ; Koushede, Vibeke. / Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT. Abstract fra 8th European Public Health Conference, MIlano, Italien.1 s.
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Brixval, CS, Thygesen, LC, Axelsen, SF, Due, P & Koushede, V 2015, 'Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT', 8th European Public Health Conference, MIlano, Italien, 14/10/2015 - 17/10/2015.

Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT. / Brixval, Carina Sjöberg; Thygesen, Lau Caspar; Axelsen, Solveig Forberg; Due, Pernille; Koushede, Vibeke.

2015. Abstract fra 8th European Public Health Conference, MIlano, Italien.

Publikation: Konferencebidrag uden forlag/tidsskriftKonferenceabstrakt til konferenceForskningpeer review

TY - ABST

T1 - Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT

AU - Brixval, Carina Sjöberg

AU - Thygesen, Lau Caspar

AU - Axelsen, Solveig Forberg

AU - Due, Pernille

AU - Koushede, Vibeke

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Background: Epidural analgesia is widely used as pain relief during labour but has negative side effects, such as prolonged labour and increased risk of obstetric interventions. Antenatal education in small groups may increase trust in own ability to cope at home in the early stages of labour, and reduce fear during birth which in turn may decrease use of pain relief. Few randomised trials have examined the effect of attending antenatal education in small groups on use of epidural analgesia and among these conclusions are conflicting. The objective of this study was therefore to examine the effect of an antenatal education program in small classes on use of epidural analgesia.Methods: Data from the NEWBORN trial were used. A total of 1766 women from the Copenhagen area, Denmark were randomized to participate in either antenatal education in small groups or standard care. Data were analysed according to the ‘intention-to-treat’ principle. Frequency of use of epidural analgesia was compared between intervention groups using the chi-square test. Unadjusted logistic regression analysis as well as analyses adjusted for the protocol specified stratification variables: parity and vulnerability were carried out.Results: At the time of writing the participants’ intervention category is blinded to the researchers and therefore results are presented blinded in this abstract. The blinding will be revealed within the next month and unblinded results can be presented at the conference. Frequency of epidural analgesia was 30.9 % in intervention category X and 29.1 % in intervention category Y (χ2 = 0.67, p=0.41).Conclusion: No differences in frequency of use of epidural analgesia were seen between intervention groups. Hence, the NEWBORN program had no effect on use of epidural analgesia in this trial. Recommendations on whether to implement the NEWBORN program in a clinical setting also depend upon the trial effect on psycho-social outcomes which will be analysed in near future.Main messages (max 200 anslag):1. No effect of antenatal education in small groups on use of epidural analgesia as pain relief during labour is seen in this Danish randomized trial2. Recommendations on whether to implement the NEWBORN program in a clinical setting requires further research on effect on other outcomes relevant to birth and parenthood.

AB - Background: Epidural analgesia is widely used as pain relief during labour but has negative side effects, such as prolonged labour and increased risk of obstetric interventions. Antenatal education in small groups may increase trust in own ability to cope at home in the early stages of labour, and reduce fear during birth which in turn may decrease use of pain relief. Few randomised trials have examined the effect of attending antenatal education in small groups on use of epidural analgesia and among these conclusions are conflicting. The objective of this study was therefore to examine the effect of an antenatal education program in small classes on use of epidural analgesia.Methods: Data from the NEWBORN trial were used. A total of 1766 women from the Copenhagen area, Denmark were randomized to participate in either antenatal education in small groups or standard care. Data were analysed according to the ‘intention-to-treat’ principle. Frequency of use of epidural analgesia was compared between intervention groups using the chi-square test. Unadjusted logistic regression analysis as well as analyses adjusted for the protocol specified stratification variables: parity and vulnerability were carried out.Results: At the time of writing the participants’ intervention category is blinded to the researchers and therefore results are presented blinded in this abstract. The blinding will be revealed within the next month and unblinded results can be presented at the conference. Frequency of epidural analgesia was 30.9 % in intervention category X and 29.1 % in intervention category Y (χ2 = 0.67, p=0.41).Conclusion: No differences in frequency of use of epidural analgesia were seen between intervention groups. Hence, the NEWBORN program had no effect on use of epidural analgesia in this trial. Recommendations on whether to implement the NEWBORN program in a clinical setting also depend upon the trial effect on psycho-social outcomes which will be analysed in near future.Main messages (max 200 anslag):1. No effect of antenatal education in small groups on use of epidural analgesia as pain relief during labour is seen in this Danish randomized trial2. Recommendations on whether to implement the NEWBORN program in a clinical setting requires further research on effect on other outcomes relevant to birth and parenthood.

KW - Antenatal education

KW - Epidural analgesia

M3 - Conference abstract for conference

ER -

Brixval CS, Thygesen LC, Axelsen SF, Due P, Koushede V. Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT. 2015. Abstract fra 8th European Public Health Conference, MIlano, Italien.