Up to 84% of women who undergo operative vaginal delivery receive neuraxial analgesia.

However, little is known about the association between neuraxial analgesia and neonatal morbidity in women who undergo operative vaginal delivery.

The authors hypothesized that neuraxial analgesia is associated with a reduced risk of neonatal morbidity among women undergoing operative vaginal delivery.

Using United States birth certificate data, the study identified women with singleton pregnancies who underwent operative vaginal (forceps- or vacuum-assisted delivery) in 2017.

The authors examined the relationships between neuraxial labor analgesia and neonatal morbidity, the latter defined by any of the following: 5-min Apgar score less than 7, immediate assisted ventilation, assisted ventilation greater than 6 h, neonatal intensive care unit admission, neonatal transfer to a different facility within 24 h of delivery, and neonatal seizure or serious neurologic dysfunction.

The authors accounted for sociodemographic and obstetric factors as potential confounders in their analysis.