Key result
Neonatal ADRB2 p.Arg16 homozygosity resulted in higher umbilical artery pH compared to other genotypes (7.31 vs 7.25; P<0.001), conferring a protective effect against ephedrine-induced fetal acidemia.
Why the study?
Does maternal and fetal ADRB2 and NOS3 genotype affect vasopressor requirement and fetal acid-base status in women receiving ephedrine or phenylephrine during spinal anesthesia for cesarean delivery?
Population
104 Chinese women scheduled for cesarean delivery under spinal anesthesia
Comparison
Ephedrine infusion for treatment of maternal… vs Phenylephrine infusion
Design
RCT, randomized, double-blind
Authors
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May inform genotype-guided vasopressor choice during cesarean delivery; extends pharmacogenomic evidence in obstetric anesthesia.
RCT (n=104)
double-blind
randomized
Does maternal and fetal ADRB2 and NOS3 genotype affect vasopressor requirement and fetal acid-base status in women receiving ephedrine or phenylephrine during spinal anesthesia for cesarean delivery?
Absolute Event Rate: 7.31% vs 7.25%
p-value: p=< 0.001
Neonatal ADRB2 p.Arg16 homozygosity confers a protective effect against developing ephedrine-induced fetal acidemia during cesarean delivery.
Landau et al. (2011) conducted an RCT in Scheduled for cesarean delivery under spinal anesthesia (n=104). Neonatal ADRB2 p.Arg16 homozygosity vs. p.16 Arg/Gly and p.16 Gly/Gly genotypes was evaluated on Umbilical artery (UA) pH (95% CI 0.03-0.09, p=< 0.001). Neonatal ADRB2 p.Arg16 homozygosity resulted in higher umbilical artery pH compared to other genotypes (7.31 vs 7.25; P<0.001), conferring a protective effect against ephedrine-induced fetal acidemia.
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