Analgesia during Labor and Vaginal Birth among Women with Severe Maternal Morbidity: Secondary Analysis from the WHO Multicountry Survey on Maternal and Newborn Health

Table 5

Potentially life-threatening conditions (PTLC) associated with analgesia during childbirth in women with severe maternal morbidity and vaginal delivery.

PLTC	With Analgesia	Without Analgesia	Prevalence Ratio (95%CI)
	601 (%)	9187 (%)
Hemorrhage
Uterine Rupture	6 (1.0)	42 (0.5)	2.18 (0.9 – 5.31)
Postpartum hemorrhage (PPH)	233 (38.8)	2474 (26.9)	1.44 (0.98 – 2.12)
Infection
Puerperal endometritis	8 (1.3)	130 (1.4)	0.94 (0.37 – 2.37)
Pyelonephritis	7 (1.2)	202 (2.2)	0.53 (0.21 – 1.34)
Influenza	3 (0.5)	88 (1.0)	0.52 (0.15 – 1.87)
Other infections	26 (4.3)	465 (5.1)	0.85 (0.35 – 2.11)
Hypertension
Chronic	29 (4.8)	452 (4.9)	0.98 (0.66 – 1.46)
Preeclampsia	145 (24.1)	2385 (26.0)	0.93 (0.74 – 1.71)
Eclampsia	7 (1.2)	339 (3.7)	0.32 (0.13 – 0.74)
Other conditions
HIV	4 (0.7)	786 (8.6)	0.08 (0.03 – 0.23)
Anemia	90 (15.0)	2030 (22.1)	0.68 (0.39 – 1.19)
Malaria / Dengue	4 (0.7)	160 (1.7)	0.38 (0.07 – 1.96)
Embolic diseases	1 (0.2)	21 (0.2)	0.73 (0.09 – 5.77)
Cancer	1 (0.2)	16 (0.2)	0.96 (0.12 – 7.42)
Heart disease	25 (4.2)	203 (2.2)	1.88 (1.01 – 3.52)
Lung disease	17 (2.8)	149 (1.6)	1.74 (1.02 – 2.99)
Renal disease	7 (1.2)	92 (1.0)	1.16 (0.47 – 2.90)
Hepatic disease	10 (1.7)	198 (2.2)	0.77 (0.42 – 1.43)
Coincidental disease	12 (2.0)	242 (2.6)	0.76 (0.14 – 4.03)
Interventions / Management
Oxytocin to PPH	197 (32.4)	2136 (23.3)	1.41 (0.93 – 2.13)
Other uterotonics to PPH	32 (5.3)	293 (3.2)	1.67 (0.79 – 3.55)
Magnesium Sulphate	49 (8.2)	1368 (14.9)	0.55 (0.36 – 0.84)
Other anticonvulsant	21 (3.5)	345 (3.8)	0.93 (0.46 – 1.90)
Antibiotics	84 (14.0)	1609 (17.5)	0.80 (0.49 – 1.30)
Blood products	78 (12.6)	1471 (16.0)	0.79 (0.55 – 1.14)
Laparotomy	10 (1.7)	56 (0.8)	2.73 (1.33 – 5.60)
Admission to ICU	31 (5.2)	392 (4.3)	1.21 (0.58 – 2.51)