LAUSR

At the onset of the COVID-19 pandemic, multiple national and international societies recommended labour epidural analgesia for patients with confirmed or suspected SARSCoV-2 infection [1, 2]. This was suggested primarily to facilitate emergency operative delivery under regional anaesthesia in order to decrease the then unknown associated risks of aerosol-generating procedures associated with general anaesthesia. A recent study by Katz et al. [3] reported that the rates of labour epidural analgesia in patients who tested positive for SARS-CoV-2 were lower than those who tested negative. Our previous work across 10maternity units in the north-west of England reported that the mean epidural labour analgesia rate amongst patients who tested positive for SARS-CoV-2 who had a vaginal birth was 20.4% [4]. In view of the findings of Katz et al. [3], and drawing on our previous data [4], we compared the rates of labour epidural analgesia in patients who tested positive for SARS-CoV-2 infection by respiratory tract reverse transcriptase polymerase chain reaction with those who were assumed, or tested, negative across nine hospitals in the north-west of England between 1 April 2020 and 31May 2021.We reviewed electronic and paper records of nine participating maternity hospitals (St. Mary’s Hospital, Liverpool Women’s Hospital, Wythenshawe Hospital, North Manchester General Hospital, Burnley General Teaching Hospital, Royal Preston Hospital, Royal Bolton Hospital, Royal Albert Edward Infirmary Wigan and Royal Oldham Hospital). The project was registered as an audit, in line with the Royal College of Anaesthetists’ guidelines for provision of anaesthesia services, which recommend collecting routine data on provision of neuraxial analgesia in labour [5]. Women in labour who tested positive for SARS-CoV-2 (n = 606) and who had received epidural analgesia (n = 124) were compared with those who were assumed, or tested, negative (n = 44,502) and who had received epidural analgesia (n = 9516). Rate ratios for epidural analgesia in labour were estimated for each hospital and