Outcomes to measure the effects of pharmacological interventions for
pain management for women during labour and birth: A review of
systematic reviews and randomised trials
Abstract
Background: Pharmacological pain management options can relieve women’s
pain during labour and birth. Trials of these interventions have used a
wide variety of outcomes, complicating meaningful comparisons of their
effects. Consensus about key outcomes would facilitate the development
of a core outcome set to assess the effectiveness of labour pain
management. Objective: To identify all outcomes used in studies of
pharmacological pain management interventions during labour and birth.
Design: A review of systematic reviews and their included randomised
controlled trials was undertaken. Search Strategy: Cochrane CENTRAL was
searched to identify all Cochrane systematic reviews describing
pharmacological pain management options for labour and birth. Search
terms included “pain management”, “labour” and variants, with no
limits on year of publication or language. Selection Criteria: Cochrane
reviews and randomised controlled trials contained within these reviews
were included, provided they compared a pharmacological intervention
with other pain management options, placebo or no treatment. Data
Collection and Analysis: All outcomes reported by reviews or trials were
extracted and tabulated, with frequencies of individual outcomes
reported. Main Results: Nine Cochrane reviews and 227 unique trials were
included. In total, 148 unique outcomes were identified and categorised
into maternal, fetal, neonatal, child, health service, provider’s
perspective, or economic outcome domains. Conclusions: Outcomes of
pharmacological pain management interventions during labour and birth
vary widely between trials. The standardisation of trial outcomes would
permit more meaningful comparison between studies. Funding: No external
funding was provided. Keywords: Labour and birth; pain management;
pharmacological interventions; systematic review