Epidural Analgesia During Labour and Severe Maternal Morbidity: Population-Based Study

( BMJ . 2024;385:e077190. http://dx.doi.org/10.1136/bmj-2023-077190) The increasing incidence of severe maternal morbidity (SMM) is a worldwide health concern impacting both mothers and their children. As outlined by the CDC, SMM encompasses 21 different conditions or procedures, such as heart attacks and childbirth-related hysterectomies. In the UK, the incidence of severe maternal morbidity (SMM) almost doubled between 2009 and 2018, possibly as a result of factors like advanced maternal age, obesity, and more concurrent health conditions. SMM is seen as a signal of maternal deaths, allowing for interventions to enhance the health of mothers and babies. Epidural analgesia (EA) is commonly advised for women with an increased chance of experiencing severe maternal morbidity (SMM), such as those with more than one pregnancy, obesity, or certain underlying health conditions, because of its physiological advantages and quick pain relief in urgent situations. Limited evidence exists to support the role of EA in preventing severe maternal morbidity (SMM).