Moderate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? A case–control study

Abstract Before 2013, almost none of the cesarean section (CS) deliveries at our institution were performed with spinal anesthesia (SA), but after 2013 SA became the first-choice anesthesia for CS because it achieved better neonatal outcomes. However, the current rate of SA implementation at our ins...

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Autores principales:	Yuki Sugo, Mirei Kubota, Hidetomo Niwa, Kazuyoshi Hirota
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e8bf354dcde045119cb43008171ec386
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spelling	oai:doaj.org-article:e8bf354dcde045119cb43008171ec3862021-12-02T15:12:52ZModerate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? A case–control study10.1038/s41598-020-80666-72045-2322https://doaj.org/article/e8bf354dcde045119cb43008171ec3862021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-80666-7https://doaj.org/toc/2045-2322Abstract Before 2013, almost none of the cesarean section (CS) deliveries at our institution were performed with spinal anesthesia (SA), but after 2013 SA became the first-choice anesthesia for CS because it achieved better neonatal outcomes. However, the current rate of SA implementation at our institution was estimated to be approx. 60–70%, which is intermediate between these at other institutions in Japan or in other countries. This raises a question: What rate of SA use among CS cases achieves the best neonatal outcomes? To answer this question, we conducted this single-center case–control study with 1326 CS cases between 1994 and 2017 and compared the neonatal outcomes before to those after 2013. The logistic regression models were prepared to estimate the risk of birth asphyxia defined as a 5-min Apgar of < 7, associated with eight potential confounders, including the modified anesthetic protocol. The modified protocol was not a significant independent factor for neonatal asphyxia, indicating that our moderate SA priority protocol did not improve the neonatal outcomes even when compared to the outcomes at a 0% SA rate. A > 70% rate of SA implementation may be needed to provide better neonatal outcomes.Yuki SugoMirei KubotaHidetomo NiwaKazuyoshi HirotaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yuki Sugo Mirei Kubota Hidetomo Niwa Kazuyoshi Hirota Moderate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? A case–control study
description	Abstract Before 2013, almost none of the cesarean section (CS) deliveries at our institution were performed with spinal anesthesia (SA), but after 2013 SA became the first-choice anesthesia for CS because it achieved better neonatal outcomes. However, the current rate of SA implementation at our institution was estimated to be approx. 60–70%, which is intermediate between these at other institutions in Japan or in other countries. This raises a question: What rate of SA use among CS cases achieves the best neonatal outcomes? To answer this question, we conducted this single-center case–control study with 1326 CS cases between 1994 and 2017 and compared the neonatal outcomes before to those after 2013. The logistic regression models were prepared to estimate the risk of birth asphyxia defined as a 5-min Apgar of < 7, associated with eight potential confounders, including the modified anesthetic protocol. The modified protocol was not a significant independent factor for neonatal asphyxia, indicating that our moderate SA priority protocol did not improve the neonatal outcomes even when compared to the outcomes at a 0% SA rate. A > 70% rate of SA implementation may be needed to provide better neonatal outcomes.
format	article
author	Yuki Sugo Mirei Kubota Hidetomo Niwa Kazuyoshi Hirota
author_facet	Yuki Sugo Mirei Kubota Hidetomo Niwa Kazuyoshi Hirota
author_sort	Yuki Sugo
title	Moderate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? A case–control study
title_short	Moderate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? A case–control study
title_full	Moderate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? A case–control study
title_fullStr	Moderate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? A case–control study
title_full_unstemmed	Moderate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? A case–control study
title_sort	moderate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? a case–control study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e8bf354dcde045119cb43008171ec386
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Moderate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? A case–control study

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