Comparison of the effects of general anesthesia and spinal analgesia on newborn's Apgar score in cesarean section

Two methods of general anesthesia and spinal analgesia are used for cesarean section. Each of these methods has special side effects and benefits for the mother and fetus. The effect of each of these methods on newborn’s Apgar score is different. Some study showed no difference between newborn’s Apgar score، but in some studies، the newborns with spinal anesthesia had lower Apgar score. This study was performed with the aim to compare the effects of used drugs in general anesthesia and spinal analgesia on newborn’s Apgar score.

This quasi-experimental study was performed on 378 mothers who were candidate for cesarean section and referred to Obstetrics clinic of Semnan Amiralmomenin Hospital. The mothers were divided in two groups of general anesthesia and spinal analgesia according to cesarean indication. After the newborn''s birth، the information related to the mother and newborn along with 1 and 5 minutes Apgar scores were recorded. Data was analyzed using SPSS software (version 18)، and Chi-square، Kolmogorov – Smirnov، T، Mann -Whitney and linear regression tests.

The mean first minute Apgar score in women with general anesthesia was 7. 81± 0. 57 and in women with spinal analgesia 8. 80 ± 0. 42 that the difference was significant (P < 0. 001). The mean fifth minutes Apgar score in women with general anesthesia was 9. 98± 0. 15 and in women with spinal analgesia 10/00 ± 0. 00 that the difference was not significant (P=0. 143). In mothers of high risk group، the mean 1st and 5th minutes Apgar score in general anesthesia were 7. 64± 0. 78 and 9. 94±0. 33 and in spinal analgesia 7. 60 ± 0. 63 and 9. 97 ± 0. 16، respectively. first minute Apgar score was significant between two groups (P < 0. 001)، but fifth minutes Apgar score was not significant between two groups (P = 0. 65).

The effect of spinal analgesia on first minute Apgar score is less than general anesthesia; therefore، it is recommended that to use spinal analgesia as much as possible in cesarean section.