Correlation between anesthetic concentration and low Apgar scores in neonates born via Cesarean sections under general anesthesia.
Anesthetics
Apgar score
Cesarean section
Correlation analysis
General anesthesia
Neonatal outcome
Journal
BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804
Informations de publication
Date de publication:
07 Sep 2024
07 Sep 2024
Historique:
received:
19
01
2024
accepted:
29
08
2024
medline:
8
9
2024
pubmed:
8
9
2024
entrez:
7
9
2024
Statut:
epublish
Résumé
This study aimed to compare plasma concentrations of anesthetic drugs administered during Cesarean section with low Apgar score in neonates deliveried under general anesthesia and analyze associated risk factors. Data from 76 neonates undergoing Cesarean section under general anesthesia with blood concentrations of anesthetic drugs were analyzed. A low Apgar score was defined as ≤ 7. Perioperative maternal and neonatal data were collected and analyzed. Neonates were divided into a control group (Group CON, n = 65) and a low Apgar score group (Group LAS, n = 11) based on Apgar score. There were no significant differences in the plasma concentrations of anesthetic drugs in maternal artery, umbilical vein or umbilical artery blood between the two groups. Risk factors for neonatal low Apgar scores during Cesarean section under general anesthesia were premature delivery (aOR 10.2, 95% CI = 1.8-56.9) and preoperative fetal distress (aOR 9.6, 95% CI = 1.3-69.0). The prediction model was: probability = 1/(e There was no correlation between blood concentration of general anesthetic drugs and Apgar score or occurrence of neonatal low Apgar scores. Premature delivery and preoperative fetal distress were identified as independent risk factors for neonatal low Apgar scores after Cesarean section under general anesthesia.
Identifiants
pubmed: 39244525
doi: 10.1186/s12887-024-05041-1
pii: 10.1186/s12887-024-05041-1
doi:
Substances chimiques
Anesthetics
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
571Subventions
Organisme : Natural Science Foundation of Chongqing of China
ID : cstc2021jcyj-msxmX0763
Organisme : National Key Clinical Speciality Construction Project
ID : Obstetrics and Gynecology
Informations de copyright
© 2024. The Author(s).
Références
Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016;388:3027–35.
doi: 10.1016/S0140-6736(16)31593-8
pubmed: 27839855
pmcid: 5161777
Lee AC, Kozuki N, Blencowe H, Vos T, Bahalim A, Darmstadt GL, et al. Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990. Pediatr Res. 2013;74(Suppl 1):50–72.
doi: 10.1038/pr.2013.206
pubmed: 24366463
pmcid: 3873711
Tunc S, Oglak SC, Gedik Ozkose Z, Olmez F. The evaluation of the antepartum and intrapartum risk factors in predicting the risk of birth asphyxia. J Obstet Gynecol Res. 2022;48:1370–8.
doi: 10.1111/jog.15214
MH J, XH W. Analysis of the occurrence and risk factors for neonatal asphyxia. Maternal Child Health Care China. 2020;35:2620–2.
American College of O. Gynecologists’ Committee on Practice B-O. ACOG Practice Bulletin 209: Obstetric Analgesia and Anesthesia. Obstet Gynecol. 2019;133:e208–25.
doi: 10.1097/AOG.0000000000003132
Cai M, Liu H, Peng Y, Miao JK, Lei XF, Yu J. Prolonged Anesthesia induction to Delivery Time did not influence plasma Remifentanil Concentration in neonates. Drug Des Devel Ther. 2023;17:1395–403.
doi: 10.2147/DDDT.S407602
pubmed: 37188282
pmcid: 10179318
Association NRGoPBoCM. Expert consensus on the diagnosis of neonatal asphyxia. Chin J Perinat Med. 2016;19:3–6.
Kurinczuk JJ, White-Koning M, Badawi N. Epidemiology of neonatal encephalopathy and hypoxic-ischemic encephalopathy. Early Hum Dev. 2010;86:329–38.
doi: 10.1016/j.earlhumdev.2010.05.010
pubmed: 20554402
Herrera-Marschitz M, Neira-Pena T, Rojas-Mancilla E, Morales P, Bustamante D, Leyton L, et al. Short- and long-term consequences of perinatal asphyxia: looking for neuroprotective strategies. Adv Neurobiol. 2015;10:169–98.
doi: 10.1007/978-1-4939-1372-5_9
pubmed: 25287541
Fisher SC, Siag K, Howley MM, Van Zutphen AR, Reefhuis J, Browne ML, et al. Maternal surgery and anesthesia during pregnancy and risk of birth defects in the National Birth defects Prevention Study, 1997–2011. Birth Defects Res. 2020;112:162–74.
doi: 10.1002/bdr2.1616
pubmed: 31840947
Szymanowski P, Szepieniec WK, Zarawski M, Gruszecki P, Szweda H, Jozwik M. The impact of birth anesthesia on the parameters of oxygenation and acid–base balance in umbilical cord blood. J Matern Fetal Neonatal Med. 2020;33:3445–52.
doi: 10.1080/14767058.2019.1574740
pubmed: 30678513
Chen Y, Liu W, Gong X, Cheng Q. Comparison of effects of General Anesthesia and combined Spinal/Epidural anesthesia for cesarean delivery on umbilical cord blood gas values: a Double-Blind, randomized, controlled study. Med Sci Monit. 2019;25:5272–9.
doi: 10.12659/MSM.914160
pubmed: 31308355
pmcid: 6652376
Staikou C, Tsaroucha A, Vakas P, Salakos N, Hasiakos D, Panoulis K, et al. Maternal and umbilical cord oxygen content and acid–base balance in relation to general, epidural or subarachnoid anesthesia for term elective cesarean section. Clin Exp Obstet Gynecol. 2013;40:367–71.
pubmed: 24283167
Wei J, Liu GL, Liang MY, Wang SM. [Effect of general anesthesia used in cesarean section on maternal-neonatal outcome of pregnancy complicated with severe Thrombocytopenia]. Zhonghua Fu Chan Ke Za Zhi. 2009;44:665–8.
pubmed: 20079177
Igboanugo S, Chen A, Mielke JG. Maternal risk factors for birth asphyxia in low-resource communities. A systematic review of the literature. J Obstet Gynecol. 2020;40:1039–55.
doi: 10.1080/01443615.2019.1679737
Sendeku FW, Azeze GG, Fenta SL. Perinatal asphyxia and its associated factors in Ethiopia: a systematic review and meta-analysis. BMC Pediatr. 2020;20:135.
doi: 10.1186/s12887-020-02039-3
pubmed: 32209083
pmcid: 7092562
Egharevba OI, Kayode-Adedeji BO, Alikah SO. Perinatal asphyxia in a rural Nigerian hospital: incidence and determinants of early outcome. J Neonatal Perinat Med. 2018;11:179–83.
doi: 10.3233/NPM-1759
Aslam HM, Saleem S, Afzal R, Iqbal U, Saleem SM, Shaikh MW, et al. Risk factors for birth asphyxia. Ital J Pediatr. 2014;40:94.
doi: 10.1186/s13052-014-0094-2
pubmed: 25526846
pmcid: 4300075
Wosenu L, Worku AG, Teshome DF, Gelagay AA. Determinants of birth asphyxia among live birth newborns in University of Gondar referral hospital, northwest Ethiopia: a case–control study. PLoS ONE. 2018;13:e0203763.
doi: 10.1371/journal.pone.0203763
pubmed: 30192884
pmcid: 6128623
Abdo RA, Halil HM, Kebede BA, Anshebo AA, Gejo NG. Prevalence and contributing factors of birth asphyxia among the neonates delivered at Nigist Eleni Mohammed memorial teaching hospital, Southern Ethiopia: a cross-sectional study. BMC Pregnancy Childbirth. 2019;19:536.
doi: 10.1186/s12884-019-2696-6
pubmed: 31888542
pmcid: 6937931
Hamza J. [Acute fetal distress. The anesthesiologist’s point of view]. Cah Anesthesiol. 1996;44:309–26.
pubmed: 9033828
Frey HA, Klebanoff MA. The epidemiology, etiology, and costs of preterm birth. Semin Fetal Neonatal Med. 2016;21:68–73.
doi: 10.1016/j.siny.2015.12.011
pubmed: 26794420
Ahmed R, Mosa H, Sultan M, Helill SE, Assefa B, Abdu M, et al. Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: a systematic review and meta-analysis. PLoS ONE. 2021;16:e0255488.
doi: 10.1371/journal.pone.0255488
pubmed: 34351953
pmcid: 8341515