International journal of obstetric anesthesia · 2025
Induction-to-delivery time interval under general anesthesia and neonatal intensive care unit admissions: a single-center retrospective cross-sectional study in planned cesarean deliveries (2014-2024).
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Ding Hui, Yin Miaomiao, Zhao Lifang, Chu Ran, Li Dongliang, Li Liang
Аннотация
BACKGROUND: Prolonged induction-to-delivery (ID) interval during general anesthesia for cesarean delivery increases fetal exposure to anesthetic agents, potentially elevating the risk of neonatal depression. We hypothesized that ID interval is associated with a higher likelihood of neonatal intensive care unit (NICU) admission in women undergoing general anesthesia for cesarean delivery.
METHODS: In this single-center retrospective study, we analyzed clinical data from 1,204 pregnant women who met the following criteria: gestational age ≥ 35 weeks, singleton pregnancy, neonatal birth weight ≥ 1800 g, and planned cesarean delivery under general anesthesia between January 2014 and September 2024. Anesthesia was administered using propofol, remifentanil, and neuromuscular blocking agents prior to delivery, with a supraglottic device. The relationship between ID time and NICU admission was assessed using multivariate logistic regression and subgroup analyses.
RESULTS: Of the 1,271 eligible cases, 67 were excluded due to stillbirth, uncertain fetal status, multiple pregnancies, or incomplete data, leaving 1,204 cases for analysis-including 204 neonates admitted to the NICU. Multivariate logistic regression analyses of ID time revealed no statistically significant associations with NICU admission. The adjusted odds ratios were 1.03 (95% confidence interval [CI], 1.00 to 1.07) for the continuous analysis and 1.01 (95% CI, 0.71 to 1.44) for the categorical analysis. Subgroup analyses, stratified by neonatal sex, gestational age, birth weight, multiparity, placenta previa, and thrombocytopenia, similarly showed no statistically significant associations between ID time interval and NICU admission.
CONCLUSION: Our findings do not support a clinically meaningful association between ID interval and NICU admission in this cohort of planned cesarean deliveries performed under general anesthesia.
METHODS: In this single-center retrospective study, we analyzed clinical data from 1,204 pregnant women who met the following criteria: gestational age ≥ 35 weeks, singleton pregnancy, neonatal birth weight ≥ 1800 g, and planned cesarean delivery under general anesthesia between January 2014 and September 2024. Anesthesia was administered using propofol, remifentanil, and neuromuscular blocking agents prior to delivery, with a supraglottic device. The relationship between ID time and NICU admission was assessed using multivariate logistic regression and subgroup analyses.
RESULTS: Of the 1,271 eligible cases, 67 were excluded due to stillbirth, uncertain fetal status, multiple pregnancies, or incomplete data, leaving 1,204 cases for analysis-including 204 neonates admitted to the NICU. Multivariate logistic regression analyses of ID time revealed no statistically significant associations with NICU admission. The adjusted odds ratios were 1.03 (95% confidence interval [CI], 1.00 to 1.07) for the continuous analysis and 1.01 (95% CI, 0.71 to 1.44) for the categorical analysis. Subgroup analyses, stratified by neonatal sex, gestational age, birth weight, multiparity, placenta previa, and thrombocytopenia, similarly showed no statistically significant associations between ID time interval and NICU admission.
CONCLUSION: Our findings do not support a clinically meaningful association between ID interval and NICU admission in this cohort of planned cesarean deliveries performed under general anesthesia.