Neonatal and early childhood outcomes following maternal anesthesia for cesarean section: a population-based cohort
Neonatal and early childhood outcomes following maternal anesthesia for cesarean section: a population-based cohort
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DOI：
10.1136/rapm-2020-102441
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发表时间：
2021-06-01
影响因子：
5.1
通讯作者：
Nelson, Scott M.
中科院分区：
文献类型：
--
作者：
Kearns, Rachel Joyce;Shaw, Martin;Nelson, Scott M.
胎儿易受母体药物暴露的影响。我们确定了脊髓麻醉、硬膜外麻醉或全身麻醉对新生儿和儿童出生后1000天发育结局的影响。方法对2007年1月至2016年12月期间苏格兰所有24+0 ~ 43+6周妊娠的单胎剖宫产孕妇进行人群研究，按分娩紧迫性分层，随访至2岁。模型根据以下因素进行了调整：产妇年龄、体重、种族、社会经济地位、吸烟、吸毒、诱导、产次、既往剖宫产或流产、先兆子痫、妊娠、出生体重和性别。结果140 866例产妇剖宫产术(41.2%（57,971/140,866）为择期剖宫产术，58.8%（82,895/140,866）为急诊剖宫产术，择期剖宫产术占3.2%(1877/57,971)，急诊剖宫产术占9.8%（8158/82,895）。在选择性病例中，全身麻醉与脊柱麻醉与新生儿复苏相关(粗事件率16.2% vs 1.9%（调整后RR 8.20, 95% CI 7.20 ~ 9.33）， Apgar
Background The 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.Methods Population-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.Results 140 866 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