The effect of mode of delivery and anaesthesia on neonatal blood pressure.

BACKGROUND

Many factors may effect blood pressure (BP) in the early neonatal period, including mode of delivery and anaesthesia, on which there is little reported.

AIMS: To determine whether the mode of delivery, anaesthesia and maternal age have an effect on neonatal BP in the first three days of life.

METHODS

Healthy, term neonates from August 2003-2005 were enrolled in the study. Infants of mothers with hypertension of any cause, diabetes of any cause, illicit substance use, congenital or chromosomal anomaly, and admission to the neonatal intensive care unit were excluded. Information on maternal age, duration of labour, mode of delivery, anaesthesia and postdelivery analgesic use was obtained. Blood pressure readings from day one to three of life were analysed.

RESULTS

Four hundred and six infants were enrolled into the study. Both spinal anaesthesia and elective caesarean delivery were associated with a lower systolic BP reading on day one, but not on day two or three (P = 0.004 and P = 0.023, respectively). Multivariate analysis indicated that spinal anaesthesia was the most significant variable for a lower systolic BP on day one (P = 0.022). There was no correlation between maternal age and BP on day one to three.

CONCLUSIONS

Spinal anaesthesia is associated with a statistically lower systolic BP on the first day of life; the clinical significance is as yet unclear.