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Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys
Associations between anaesthetic techniques and pregnancy outcomes were assessed among 129,742 pregnancies delivered by caesarean section (CS) in low- and middle-income countries (LMICs) using two WHO databases. Anaesthesia was categorized as general anaesthesia (GA) and neuraxial anaesthesia (NA)....
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311389/ https://www.ncbi.nlm.nih.gov/pubmed/32576845 http://dx.doi.org/10.1038/s41598-020-66897-8 |
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author | Lumbiganon, Pisake Moe, Hla Kamsa-ard, Siriporn Rattanakanokchai, Siwanon Laopaiboon, Malinee Kietpeerakool, Chumnan Jampathong, Nampet Somjit, Monsicha Cecatti, José Guilherme Vogel, Joshua P. Betran, Ana Pilar Mittal, Suneeta Torloni, Maria Regina |
author_facet | Lumbiganon, Pisake Moe, Hla Kamsa-ard, Siriporn Rattanakanokchai, Siwanon Laopaiboon, Malinee Kietpeerakool, Chumnan Jampathong, Nampet Somjit, Monsicha Cecatti, José Guilherme Vogel, Joshua P. Betran, Ana Pilar Mittal, Suneeta Torloni, Maria Regina |
author_sort | Lumbiganon, Pisake |
collection | PubMed |
description | Associations between anaesthetic techniques and pregnancy outcomes were assessed among 129,742 pregnancies delivered by caesarean section (CS) in low- and middle-income countries (LMICs) using two WHO databases. Anaesthesia was categorized as general anaesthesia (GA) and neuraxial anaesthesia (NA). Outcomes included maternal death (MD), maternal near miss (MNM), severe maternal outcome (SMO), intensive care unit (ICU) admission, early neonatal death (END), neonatal near miss (NNM), severe neonatal outcome (SNO), Apgar score <7 at 5 minutes, and neonatal ICU (NICU) admission. A two‐stage approach of individual participant data meta‐analysis was used to combine the results. Adjusted odds ratio (OR) with 95% confidence intervals (CIs) were presented. Compared to GA, NA were associated with decreased odds of MD (pooled OR 0.28; 95% CI 0.10, 0.78), MNM (pooled OR 0.25; 95% CI 0.21, 0.31), SMO (pooled OR 0.24; 95% CI 0.20,0.28), ICU admission (pooled OR 0.17; 95% CI 0.13, 0.22), NNM (pooled OR 0.63; 95% CI 0.55, 0.73), SNO (pooled OR 0.55; 95% CI 0.48, 0.63), Apgar score <7 at 5 minutes (pooled OR 0.35; 95% CI 0.29, 0.43), and NICU admission (pooled OR 0.53; 95% CI 0.45, 0.62). NA therefore was associated with decreased odds of adverse pregnancy outcomes in LMICs. |
format | Online Article Text |
id | pubmed-7311389 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-73113892020-06-25 Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys Lumbiganon, Pisake Moe, Hla Kamsa-ard, Siriporn Rattanakanokchai, Siwanon Laopaiboon, Malinee Kietpeerakool, Chumnan Jampathong, Nampet Somjit, Monsicha Cecatti, José Guilherme Vogel, Joshua P. Betran, Ana Pilar Mittal, Suneeta Torloni, Maria Regina Sci Rep Article Associations between anaesthetic techniques and pregnancy outcomes were assessed among 129,742 pregnancies delivered by caesarean section (CS) in low- and middle-income countries (LMICs) using two WHO databases. Anaesthesia was categorized as general anaesthesia (GA) and neuraxial anaesthesia (NA). Outcomes included maternal death (MD), maternal near miss (MNM), severe maternal outcome (SMO), intensive care unit (ICU) admission, early neonatal death (END), neonatal near miss (NNM), severe neonatal outcome (SNO), Apgar score <7 at 5 minutes, and neonatal ICU (NICU) admission. A two‐stage approach of individual participant data meta‐analysis was used to combine the results. Adjusted odds ratio (OR) with 95% confidence intervals (CIs) were presented. Compared to GA, NA were associated with decreased odds of MD (pooled OR 0.28; 95% CI 0.10, 0.78), MNM (pooled OR 0.25; 95% CI 0.21, 0.31), SMO (pooled OR 0.24; 95% CI 0.20,0.28), ICU admission (pooled OR 0.17; 95% CI 0.13, 0.22), NNM (pooled OR 0.63; 95% CI 0.55, 0.73), SNO (pooled OR 0.55; 95% CI 0.48, 0.63), Apgar score <7 at 5 minutes (pooled OR 0.35; 95% CI 0.29, 0.43), and NICU admission (pooled OR 0.53; 95% CI 0.45, 0.62). NA therefore was associated with decreased odds of adverse pregnancy outcomes in LMICs. Nature Publishing Group UK 2020-06-23 /pmc/articles/PMC7311389/ /pubmed/32576845 http://dx.doi.org/10.1038/s41598-020-66897-8 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Lumbiganon, Pisake Moe, Hla Kamsa-ard, Siriporn Rattanakanokchai, Siwanon Laopaiboon, Malinee Kietpeerakool, Chumnan Jampathong, Nampet Somjit, Monsicha Cecatti, José Guilherme Vogel, Joshua P. Betran, Ana Pilar Mittal, Suneeta Torloni, Maria Regina Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys |
title | Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys |
title_full | Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys |
title_fullStr | Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys |
title_full_unstemmed | Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys |
title_short | Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys |
title_sort | outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of who surveys |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311389/ https://www.ncbi.nlm.nih.gov/pubmed/32576845 http://dx.doi.org/10.1038/s41598-020-66897-8 |
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