What is the clinical evidence from this study?

Study design: Cohort. Population: Cesarean section (neonatal outcomes) (n=997). Intervention: General anesthesia vs. Spinal anesthesia. Primary outcome: Respiratory distress syndrome (RDS) (OR 1.835, p=0.038).

What does this research mean for the field?

General anesthesia during cesarean delivery is associated with an increased risk of neonatal respiratory distress syndrome and worse neonatal outcomes compared to spinal anesthesia. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the association between the type of anesthesia—general anesthesia versus spinal anesthesia—during elective or emergency cesarean section and neonatal morbidity and mortality.

June 14, 2026Local and Regional AnesthesiaOpen Access

Mode of Anesthesia During Cesarean Section and Neonatal Morbidity and Mortality: A Cohort Study

View Full Paper

Ask AI

Bookmark

Key result

General anesthesia during cesarean linked to ~84% higher neonatal RDS risk versus spinal anesthesia.

OR 1.835
P=0.038
n=997

Why the study?

The influence of obstetric anesthesia on neonates remains under investigation.

Does spinal anesthesia improve neonatal outcomes compared to general anesthesia in neonates born via cesarean section?

Key Points

To evaluate the association between the type of anesthesia—general anesthesia versus spinal anesthesia—during elective or emergency cesarean section and neonatal morbidity and mortality.
Conducted a retrospective cohort study of 997 neonates admitted to the neonatal intensive care unit following elective or emergency cesarean delivery between 2017 and 2021.
Categorized patients by maternal anesthesia exposure into spinal anesthesia (n = 628) and general anesthesia (n = 369) cohorts and analyzed neonatal outcomes using univariate tests and multivariate logistic regression.
Spinal anesthesia was associated with significantly higher 5-minute Apgar scores (8.56 ± 0.04 vs 8.16 ± 0.05, P =0.0001) and lower neonatal mortality (4% vs 10.8%, P =0.0001) compared with general anesthesia.
Neonates exposed to general anesthesia exhibited higher rates of respiratory distress syndrome (42.3% vs 35.5%, P =0.02) and intraventricular hemorrhage (13.6% vs 0.8%, P =0.0001), but a lower rate of transient tachypnea of the newborn (6.2% vs 12.6%, P =0.001).

Study Design

Type

Cohort (n=997)

Multicenter

Structured PICO

Does spinal anesthesia improve neonatal outcomes compared to general anesthesia in neonates born via cesarean section?

Population

997 neonates admitted to the NICU following maternal elective or emergency cesarean section, comparing outcomes between spinal and general anesthesia.

Exposure

Spinal anesthesia (SA) using 0.5% heavy bupivacaine and fentanyl

Comparator

General anesthesia (GA) using propofol, rocuronium, and isoflurane

Outcome

Difference between spinal anesthesia and general anesthesia in regard to neonatal outcomeshard clinical

Main Result

Odds Ratio: 1.835

Absolute Event Rate: 42.3% vs 35.5%

p-value: p=0.038

General anesthesia during cesarean section is associated with worse neonatal outcomes, including higher mortality and respiratory distress syndrome, compared to spinal anesthesia, though this may be confounded by its use in higher-grade emergencies.

Limitations

Retrospective design
Study population was restricted to NICU-admitted neonates
Majority of patients receiving general anesthesia underwent emergency cesarean sections, introducing confounding by indication
Maternal comorbidities and obstetric complications may largely account for the observed outcome differences
Single-center study
Selection bias (GA utilized more frequently in higher-grade emergencies with more adverse baseline predictors)

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Observational data on anesthesia type in cesarean delivery may inform risk discussions; leaves open causal neonatal effects pending randomized trials.

Cite This Study

Alhowary et al. (2026) conducted a cohort in Cesarean section (neonatal outcomes) (n=997). General anesthesia vs. Spinal anesthesia was evaluated on Respiratory distress syndrome (RDS) (OR 1.835, p=0.038). General anesthesia during cesarean section was associated with a significantly higher risk of neonatal respiratory distress syndrome compared to spinal anesthesia (42.3% vs 35.5%, OR 1.835).

synapsesocial.com/papers/6a2e44e4b1cc60ccdea8a501 https://doi.org/10.2147/lra.s582928

View Full Paper

Ask AI

Bookmark

Implication

Observational data on anesthesia type in cesarean delivery may inform risk discussions; leaves open causal neonatal effects pending randomized trials.

Mode of Anesthesia During Cesarean Section and Neonatal Morbidity and Mortality: A Cohort Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Mode of Anesthesia During Cesarean Section and Neonatal Morbidity and Mortality: A Cohort Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider