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

El-Kabbany, Zeinab A.; Toaima, Nadin N.; Toaima, Tamer N; EL-Din, Mona Y Gamal

doi:10.3345/kjp.2017.60.12.385

Cited by 4 publications

(4 citation statements)

References 16 publications

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“…10,11 In a study in which newborn bilirubin levels with general anesthesia and NSVD were compared, 24-hour serum bilirubin values were found to be high, although not statistically significant. 12 El Kabbany et al 13 there is a current study reporting that maternal general anesthesia has a negative effect on newborn bilirubin. In our study, we found that the 1st hour bilirubin and 4 th hour bilirubin values in the general anesthesia group were significantly higher than the group that did not receive anesthesia (p<0.05, p=0.001).…”

Section: Discussionmentioning

confidence: 86%

The effect of general anesthesia applied during cesarean section on newborn bilirubin

Turan,

Karayel

2023

KMJ

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Aims: Today, delivery is often performed as normal spontaneous vaginal delivery (NSVD) and cesarean section operations. Deliveries with NSVD mostly take place in the delivery room without the need for additional anesthetic agents. General anesthesia and regional anesthesia techniques are applied in cesarean section operations. In this study; The aim of this study was to examine the effect of general anesthesia on newborn bilirubin and to compare it with the bilirubin level of babies born without general anesthesia with NSVD method. Methods: Between March 2022 and September 2022, 152 patients over the age of 18 with term pregnancy NSVD and elective cesarean section without complications were randomly included in the study. Cases diagnosed with liver and biliary tract disease, systemic liver and biliary tract effective drug use, DCOOMBS( +) and Covid (+) clinics were excluded. Results: Of the patients included in our study, 75 (49.3%) were given general anesthesia and 77 (50.7%) delivered with NSVD without general anesthesia. It was determined that the first hour bilirubin and the fourth hour bilirubin values were significantly higher (p <0.05) in the general anesthesia group compared to the group that did not receive general anesthesia. In the group that did not receive general anesthesia, the APGAR 5th min score was found to be significantly (p <0.05) higher than the general anesthesia group. APGAR 1 min value did not differ significantly (p > 0.05) between the anesthesia-free and general anesthesia groups. Neonatal weight, head circumference, and infant height did not differ significantly between the groups that did not receive general anesthesia and those who did not receive general anesthesia (p> 0.05). Conclusion: Among the groups that did not receive general anesthesia and anesthesia; Bilirubin value was found to be higher among babies born by cesarean section under general anesthesia. It seems that it is more beneficial to avoid systemic effects as much as possible and to disseminate NSVD.

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Section: Discussionmentioning

confidence: 86%

The effect of general anesthesia applied during cesarean section on newborn bilirubin

Turan,

Karayel

2023

KMJ

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“…Newborns of women administered synthetic oxytocin in labour also have higher risks of jaundice, likely due to increased erythrocyte fragility [ 215 – 218 ]. Studies have also found that newborns of exposed women have lower levels of glutathione and markers that indicate more oxidative stress, compared to newborns of unexposed women, likely due to hypoxic effects [ 219 – 221 ].…”

Section: Discussionmentioning

confidence: 99%

Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum – a systematic review with implications for the function of the oxytocinergic system

Buckley

Uvnäs‐Moberg

Pajalić

et al. 2023

BMC Pregnancy Childbirth

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Background The reproductive hormone oxytocin facilitates labour, birth and postpartum adaptations for women and newborns. Synthetic oxytocin is commonly given to induce or augment labour and to decrease postpartum bleeding. Aim To systematically review studies measuring plasma oxytocin levels in women and newborns following maternal administration of synthetic oxytocin during labour, birth and/or postpartum and to consider possible impacts on endogenous oxytocin and related systems. Methods Systematic searches of PubMed, CINAHL, PsycInfo and Scopus databases followed PRISMA guidelines, including all peer-reviewed studies in languages understood by the authors. Thirty-five publications met inclusion criteria, including 1373 women and 148 newborns. Studies varied substantially in design and methodology, so classical meta-analysis was not possible. Therefore, results were categorized, analysed and summarised in text and tables. Results Infusions of synthetic oxytocin increased maternal plasma oxytocin levels dose-dependently; doubling the infusion rate approximately doubled oxytocin levels. Infusions below 10 milliunits per minute (mU/min) did not raise maternal oxytocin above the range observed in physiological labour. At high intrapartum infusion rates (up to 32 mU/min) maternal plasma oxytocin reached 2–3 times physiological levels. Postpartum synthetic oxytocin regimens used comparatively higher doses with shorter duration compared to labour, giving greater but transient maternal oxytocin elevations. Total postpartum dose was comparable to total intrapartum dose following vaginal birth, but post-caesarean dosages were higher. Newborn oxytocin levels were higher in the umbilical artery vs. umbilical vein, and both were higher than maternal plasma levels, implying substantial fetal oxytocin production in labour. Newborn oxytocin levels were not further elevated following maternal intrapartum synthetic oxytocin, suggesting that synthetic oxytocin at clinical doses does not cross from mother to fetus. Conclusions Synthetic oxytocin infusion during labour increased maternal plasma oxytocin levels 2–3-fold at the highest doses and was not associated with neonatal plasma oxytocin elevations. Therefore, direct effects from synthetic oxytocin transfer to maternal brain or fetus are unlikely. However, infusions of synthetic oxytocin in labour change uterine contraction patterns. This may influence uterine blood flow and maternal autonomic nervous system activity, potentially harming the fetus and increasing maternal pain and stress.

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“…These factors caused bilirubin accumulation and led to ABE ( 21 ). The type of delivery also affected the risk of ABE; cesarean births were more likely to develop ABE, and this may be related to anesthesia ( 22 , 23 ). In the radiomics model, the selected features were composed of the following categories: one first-order feature (Left_Skewness), two shape features (Right_SurfaceVolumeRatio and Left_Maximum2DDiameterRow), and seven texture features (Right_ RunEntropy, Left_Correlation, Right_SmallAreaLowGrayEmphasis, Right_Imc1, Right_Correlation, Left_GrayLevelNonUniformity_2, and Left_Idmn).…”

Section: Discussionmentioning

confidence: 99%

Development and evaluation clinical-radiomics analysis based on T1-weighted imaging for diagnosing neonatal acute bilirubin encephalopathy

Liu²,

Jiang³

et al. 2023

Front. Neurol.

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PurposeTo investigate the value of clinical-radiomics analysis based on T1-weighted imaging (T1WI) for predicting acute bilirubin encephalopathy (ABE) in neonates.MethodsIn this retrospective study, sixty-one neonates with clinically confirmed ABE and 50 healthy control neonates were recruited between October 2014 and March 2019. Two radiologists' visual diagnoses for all subjects were independently based on T1WI. Eleven clinical and 216 radiomics features were obtained and analyzed. Seventy percent of samples were randomly selected as the training group and were used to establish a clinical-radiomics model to predict ABE; the remaining samples were used to validate the performance of the models. The discrimination performance was assessed by receiver operating characteristic (ROC) curve analysis.ResultsSeventy-eight neonates were selected for training (median age, 9 days; interquartile range, 7–20 days; 49 males) and 33 neonates for validation (median age, 10 days; interquartile range, 6–13 days; 24 males). Two clinical features and ten radiomics features were finally selected to construct the clinical-radiomics model. In the training group, the area under the ROC curve (AUC) was 0.90 (sensitivity: 0.814; specificity: 0.914); in the validation group, the AUC was 0.93 (sensitivity: 0.944; specificity: 0.800). The AUCs of two radiologists' and the radiologists' final visual diagnosis results based on T1WI were 0.57, 0.63, and 0.66, respectively. The discriminative performance of the clinical-radiomics model in the training and validation groups was increased compared to the radiologists' visual diagnosis (P < 0.001).ConclusionsA combined clinical-radiomics model based on T1WI has the potential to predict ABE. The application of the nomogram could potentially provide a visualized and precise clinical support tool.

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

Cited by 4 publications

References 16 publications

The effect of general anesthesia applied during cesarean section on newborn bilirubin

The effect of general anesthesia applied during cesarean section on newborn bilirubin

Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum – a systematic review with implications for the function of the oxytocinergic system

Development and evaluation clinical-radiomics analysis based on T1-weighted imaging for diagnosing neonatal acute bilirubin encephalopathy

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