Neonatal and early childhood outcomes following maternal anesthesia for cesarean section: a population-based cohort study
| Autor: | Piotr S. Gromski, Stamatina Iliodromiti, Martin Shaw, Scott M. Nelson, Jill P. Pell, Debbie A Lawlor, Rachel J. Kearns |
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| Rok vydání: | 2021 |
| Předmět: |
Resuscitation
Birth weight Population Gestational Age Anesthesia General Abortion Cohort Studies Pregnancy Humans Medicine Early childhood education Socioeconomic status Retrospective Studies Fetus education.field_of_study Cesarean Section business.industry Infant Newborn General Medicine Anesthesiology and Pain Medicine Child Preschool Anesthesia Gestation Female business Neonatal resuscitation |
| Zdroj: | Regional Anesthesia & Pain Medicine. 46:482-489 |
| ISSN: | 1532-8651 1098-7339 |
| DOI: | 10.1136/rapm-2020-102441 |
| Popis: | BackgroundThe fetus is vulnerable to maternal drug exposure. We determined associations of exposure to spinal, epidural, or general anesthesia on neonatal and childhood development outcomes during the first 1000 days of life.MethodsPopulation-based study of all singleton, cesarean livebirths of 24+0 to 43+6 weeks gestation between January 2007 and December 2016 in Scotland, stratified by urgency with follow-up to age 2 years. Models were adjusted for: maternal age, weight, ethnicity, socioeconomic status, smoking, drug-use, induction, parity, previous cesarean or abortion, pre-eclampsia, gestation, birth weight, and sex.Results140 866 mothers underwent cesarean section (41.2% (57,971/140,866) elective, 58.8% (82,895/140,866) emergency) with general anesthesia used in 3.2% (1877/57,971) elective and 9.8% (8158/82,895) of emergency cases. In elective cases, general anesthesia versus spinal was associated with: neonatal resuscitation (crude event rate 16.2% vs 1.9% (adjusted RR 8.20, 95% CI 7.20 to 9.33), Apgar ConclusionsGeneral anesthesia for cesarean section, irrespective of urgency, is associated with neonatal resuscitation, low Apgar, and neonatal unit admission. Associations were strongest in non-urgent cases and at term. Further evaluation of long-term outcomes is warranted. |
| Databáze: | OpenAIRE |
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