Journal article
The Association of Anesthesia Type and Neonatal Outcomes Following Category-1 Cesarean Delivery: A Retrospective Cohort Study
Curēus (Palo Alto, CA), Vol.15(3), e35910
03/2023
DOI: 10.7759/cureus.35910
PMCID: PMC10081886
PMID: 37033505
Abstract
Objectives
Neuraxial anesthesia is the preferred anesthesia technique for cesarean delivery due to a decreased risk of adverse events. However, general anesthesia is often employed during emergent cesarean deliveries to achieve a shorter decision-to-delivery interval. The objective of this study was to determine if the conversion of epidural labor analgesia to surgical anesthesia for a category-1 cesarean delivery is associated with significant neonatal morbidity.
Study design
This was a retrospective cohort study of all intrapartum category-1 cesarean deliveries performed at an academic tertiary care institution between August 2016 and July 2021. The primary outcome was neonatal morbidity, defined as a composite of neonatal umbilical artery pH < 7.10 and/or 5‐min Apgar score < 7, and/or neonatal intensive care unit admission. A multivariate regression analysis was performed to control for the presence of covariates and examine the degree to which they influenced the outcome.
Results
A total of 185 mother-neonate pairs qualified for inclusion, of which 23 had cesarean delivery under general anesthesia and 162 under epidural anesthesia. There was no significant difference in adverse neonatal outcomes between category-1 cesarean deliveries done under general anesthesia compared to epidural anesthesia (47% vs 35%, p = 0.3). The incidence of umbilical arterial pH < 7.10 was higher in the general anesthesia group compared to the epidural anesthesia group (35% vs 12%, p = 0.018). The multivariate regression model showed that gestational age (OR = 0.63; 95% CI = 0.51-0.75, p = <0.001) and non-reassuring fetal heart trace (OR = 0.18; 95% CI = 0.05-0.58, p = 0.005) were significant predictors of adverse neonatal outcome.
Conclusion
Our results suggest that the conversion of epidural analgesia to surgical anesthesia for category-1 cesarean delivery in women with a functional labor epidural catheter is not associated with poorer neonatal outcomes.
Details
- Title: Subtitle
- The Association of Anesthesia Type and Neonatal Outcomes Following Category-1 Cesarean Delivery: A Retrospective Cohort Study
- Creators
- Carl M Skoog - University of IowaJoel F Katzer - University of IowaLinder H Wendt - University of IowaUnyime Ituk - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Curēus (Palo Alto, CA), Vol.15(3), e35910
- DOI
- 10.7759/cureus.35910
- PMID
- 37033505
- PMCID
- PMC10081886
- NLM abbreviation
- Cureus
- ISSN
- 2168-8184
- eISSN
- 2168-8184
- Publisher
- Cureus
- Language
- English
- Date published
- 03/2023
- Academic Unit
- Anesthesia
- Record Identifier
- 9984388756902771
Metrics
35 Record Views