Effect of anesthesiological strategies on neonatal bilirubin levels during cesarean section: a prospective and randomized trial

Demiraran, Yavuz; Albayrak, Mustafa; Şeker, İlknur Suidiye; Kaynak, Gursel; Iskender, Abdülkadir; Sezen, Gülbin; Özdemir, İsmail

doi:10.1007/s00404-010-1783-8

Cited by 10 publications

(9 citation statements)

References 15 publications

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“…The present study showed significantly higher bilirubin levels in group of general anaesthesia compared to the group where mothers received spinal anesthesia ( P <0.001). This is in agreement with the Turkish study by Demiraran et al 11) ; where significantly higher direct bilirubin levels at 5th day in the total intravenous anesthesia (TIVA) group compared to spinal anesthesia group.…”

Section: Discussionsupporting

confidence: 93%

Does anaesthesia in mothers during delivery affect bilirubin levels in their neonates?

El-Kabbany

Toaima

et al. 2017

Korean J Pediatr

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PurposeThis study aimed to assess whether different anesthetic techniques and oxytocin use applied during delivery affect transcutaneous bilirubin levels during the first 24 hours in neonates.MethodsA total of 1,044 neonates delivered by either caesarian section (C/S) or normal vaginal delivery (NVD) were included in the study. They were classified into 5 groups as follows: group 1: born by C/S using general anesthesia, group 2: C/S using spinal anaesthesia, group 3: C/S using general anesthesia after failed spinal block, group 4: by NVD without anesthesia, and group 5: oxytocin-induced vaginal delivery without anesthesia. Transcutaneous total bilirubin levels (TBLs) were measured during the first 24 hours and on the fifth and eighth days of life and the levels in different groups were compared.ResultsThe TBLs were significantly higher in neonates delivered by C/S using general anesthesia rather than spinal anesthesia (P<0.001), and both groups had higher levels than those born by NVD without anesthesia (P≤0.001). However, the group receiving general anesthesia after failed spinal block was found to have the highest bilirubin level. Moreover, TBLs were significantly higher with the use of oxytocin (P≤0.001).ConclusionsC/S and general anesthesia adversely affect the bilirubin levels in neonates, and the use of oxytocin during vaginal delivery also increases TBLs in neonates.

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Section: Discussionsupporting

confidence: 93%

Does anaesthesia in mothers during delivery affect bilirubin levels in their neonates?

El-Kabbany

Toaima

et al. 2017

Korean J Pediatr

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“…Spinal anesthesia is generally preferred for cesarean delivery. 24,[11][12][13][14][33][34][35] Spinal anesthesia is superior to general anesthesia for neonatal acid-base status and Apgar score, 24,33,35,[11][12][13][14] and possibly also for neurobehavioral status and need for assisted ventilation. 35,36 Nonetheless, the results of our randomized controlled trials were not consistent, with some studies reporting no differences between general and neuraxial anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Comparison between general, spinal, epidural, and combined spinal-epidural anesthesia for cesarean delivery: a network meta-analysis

Kim

Hur

Park

et al. 2019

International Journal of Obstetric Anesthesia

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Background: This study is a network meta-analysis to compare maternal and fetal outcomes associated with four different anesthetic techniques for cesarean delivery. Methods: An arm-based, random-effects frequentist network meta-analysis was performed. A random effect model was selected considering deviance information criteria. Randomized trials reporting the following outcomes were included: Apgar score at 1-or 5-min; umbilical arterial and venous pH; umbilical arterial pH <7.2; and neonatal score at 2-4 hours. Loop-specific heterogeneity was evaluated by risk of odds ratio and s 2. Quality of evidence was assessed using the GRADE approach. Results: Data from 46 randomized trials including 3689 women contributed to the study. There were significant differences in Apgar score 6 at 1 min between spinal versus general anesthesia (odds ratio 0.27, 95% confidence interval [CI] 0.13 to 0.55: moderate quality evidence) and Apgar scores at 1-and 5-min, favoring spinal anesthesia. Umbilical venous pH associated with epidural anesthesia was significantly higher than that with general anesthesia (mean difference 0.010, 95% CI 0.001 to 0.020: moderate quality evidence) or spinal anesthesia. Spinal anesthesia was ranked best for Apgar score 6 at 1-min (SUCRA=89.8), Apgar score at 1-min (SUCRA=80.4) and 5-min (SUCRA=90.5). Epidural anesthesia was ranked highest for umbilical venous pH (SUCRA=87.4) and neonatal score (SUCRA=79.3). Conclusions: Spinal and epidural anesthesia were ranked high regarding Apgar scores and epidural anesthesia was ranked high regarding umbilical venous pH, but the results were based on small heterogeneous studies with high or unclear risks of bias.

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“…Past studies show that epidural or spinal anesthesia before cesarean has fewer side effects than other methods. However, general anesthesia is considered as a risk factor for jaundice (14). Based on the findings of another study, there is no relationship between the type of delivery and the severity of jaundice in newborns (15).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Serum Zinc Level Between Neonates With Jaundice and Healthy Neonates

et al. 2015

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Background: Neonatal jaundice is the most common cause of hospitalization in the first month of life. Factors that reportedly affect the severity of neonatal jaundice include: maternal, prenatal and neonatal factors as well as environmental factors (such as zinc). Animal study demonstrated a decrease in serum bilirubin level after zinc treatment in hyperbilirubinemic rats. Objectives: The current study aimed to investigate serum zinc level in the neonates with idiopatic jaundice. Patients and Methods: A case-control study was undertaken from 2008 to 2010 on 263 neonates in a neonatal intensive care unit and obstetrics department in Ghaem hospital, Mashhad, Iran. Of the 263 infants, 114 and 149 neonates were in the control and the case groups, respectively. Infants with a gestational age of >35 weeks or with idiopathic jaundice were included in the study. Exclusion criteria were as follows: neonates with sepsis or any congenital abnormalities or with glucose-6-phosphate dehydrogenase (G-6PD) deficiency, ABO and RH incompatibility. Serum levels of zinc and bilirubin were compared between the control (114 neonates without jaundice) and case (149 neonates with jaundice) groups using atomic absorption spectrometry. The maternal and neonatal information were recorded. Spearman correlation coefficient, chi-square and Mann-Whitney tests were employed to analyze the data by SPSS software. Results: The mean value of the zinc serum level was 1024.74 ± 245.17 μmol/L in the control group and 841.42 ± 211.99 μmol/L in the case group (P < 0.001). There was no significant correlation between zinc level and factors such as maternal age, multi parity, mode of delivery, hospitalization and gender of infants (P > 0.05). Also, no significant correlation was observed between serum levels of Na, blood urea nitrogen (BUN), creatinine (Cr), white blood cell (WBC), platelet, hematocrit (Hct) and zinc (P > 0.05). Conclusions:The level of serum zinc in the neonates with hyperbilirubinemia jaundice was lower than that of the ones without jaundice. It seems that zinc has a protective effect. However, more studies are needed for better decision making.

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Effect of anesthesiological strategies on neonatal bilirubin levels during cesarean section: a prospective and randomized trial

Cited by 10 publications

References 15 publications

Does anaesthesia in mothers during delivery affect bilirubin levels in their neonates?

Does anaesthesia in mothers during delivery affect bilirubin levels in their neonates?

Comparison between general, spinal, epidural, and combined spinal-epidural anesthesia for cesarean delivery: a network meta-analysis

Comparison of Serum Zinc Level Between Neonates With Jaundice and Healthy Neonates

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