Key result
Higher maternal risk burden during cesarean sections linked to lower Apgar scores and NICU admissions.
Why the study?
The number of high-risk pregnancies is increasing in tertiary medical centers, prompting an investigation of perioperative outcomes based on risk factors to ascertain proper maternal and neonatal management.
Does the number of maternal clinical risk factors affect perioperative and neonatal outcomes in patients undergoing high-risk cesarean section?
Cohort
No
Does the number of maternal clinical risk factors affect perioperative and neonatal outcomes in patients undergoing high-risk cesarean section?
An increasing number of maternal risk factors in high-risk pregnancies undergoing cesarean section is associated with progressively worse neonatal outcomes and increased maternal blood loss.
Supports heightened neonatal vigilance in high-risk cesareans; leaves open whether risk-factor modification improves outcomes.
Objective The number of high-risk pregnancies is increasing in tertiary medical centers. Therefore, we investigated perioperative outcomes based on risk factors to ascertain proper maternal and neonatal management. Methods We reviewed the medical records of patients receiving cesarean sections over an 8-year period. Clinical parameters for anesthesia and the neonatal outcome were compared among high-risk groups after subdivision by the number of clinical risk factors. The groups were as follows: group A (one risk factor), group B (two risk factors), and group C (three or more risk factors). Results Patient age, estimated blood loss (EBL), and volume of transfused red blood cell (RBC) were higher in group B than group A. Birth weight, 1- and 5-minute Apgar scores, and gestational age were lower while the frequency of neonatal intensive care unit (NICU) admission was higher in group B than group A. Group C patients were significantly older than group A or B patients. Birth weight, 1- and 5-minute Apgar scores and gestational age were significantly lower while frequency of NICU admission was higher in group C than group A and B. Conclusion The number of maternal risk factors was positively associated with adverse outcomes in the neonates.
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Kang et al. (2019) conducted a cohort in High-risk pregnancy requiring cesarean section. Multiple maternal clinical risk factors vs. Single maternal clinical risk factor was evaluated on Perioperative maternal and neonatal outcomes. A higher number of maternal risk factors during cesarean sections was positively associated with adverse neonatal outcomes, including lower Apgar scores and increased NICU admissions.
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