Effects of epidural labor analgesia on intrapartum fever and obstetric outcomes in women with gestational diabetes mellitus: A retrospective cohort study.

Gestational diabetes mellitus (GDM) is a common metabolic disorder during pregnancy, closely associated with adverse maternal and neonatal outcomes. Epidural labor analgesia (ELA) is widely used for pain relief during labor, but it has also been linked to an increased incidence of intrapartum fever. Although previous studies have explored the effects of ELA on the general population, it remains unclear whether it has a greater impact on women with GDM, leading to higher risks of intrapartum fever, prolonged labor, and adverse mode of delivery. This retrospective cohort study included 234 parturients between January and December 2023, categorized into 3 groups: Group A (GDM with ELA, n = 85), Group B (GDM without ELA, n = 64), and Group C (non-GDM with ELA, n = 85). To reduce potential confounding, propensity score matching (PSM) was applied. The primary outcomes assessed were intrapartum fever incidence, labor duration, and mode of delivery. Group A had significantly longer labor durations (688.99 ± 400.54 minutes vs 377.97 ± 319.66 minutes, P < .01), higher cesarean delivery rates (14.10% vs 4.70%, P = .01), and a greater incidence of intrapartum fever (21.20% vs 1.60%, P < .01) compared to Group B. No statistically significant differences were found between Group A and Group C. In nulliparous women with GDM, ELA is associated with prolonged labor, increased cesarean delivery rates, and a higher risk of intrapartum fever. These findings suggest that individualized analgesic strategies should be considered in GDM pregnancies to minimize potential complications.