A Retrospective Comparative Analysis of Epidural Analgesia and Its Impact on Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios During Vaginal Delivery

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Introduction: Epidural analgesia is a widely used method for managing labor pain. While effective in pain relief, its potential effects on maternal systemic inflammation during labor remain unclear. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are established biomarkers for systemic inflammation and may provide insights into the inflammatory dynamics associated with epidural analgesia. This study aims to investigate the impact of epidural analgesia on NLR and PLR values in women undergoing normal vaginal delivery. Methods: A retrospective case-control study was conducted involving 100 women with singleton pregnancies, evenly divided into two groups based on whether they received epidural analgesia. Hematological parameters, including NLR and PLR, were measured and analyzed. Labor duration and white blood cell (WBC) counts were also compared between groups. Results: No significant differences in NLR (p = 0.79) or PLR (p = 0.59) values were observed between the epidural and non-epidural groups. However, WBC counts were significantly higher in the epidural group (p = 0.007), and labor duration was prolonged (p < 0.001) compared to the non-epidural group. Conclusion: Epidural analgesia does not significantly influence NLR and PLR values, suggesting minimal systemic inflammatory effects. However, the observed increase in WBC counts and prolonged labor duration highlight the need for individualized monitoring and care. These findings provide further evidence supporting the safe use of epidural analgesia in normal vaginal delivery while identifying areas for future research.

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