The Impact of Maternal Spinal Anesthesia on Newborn Out-Comes: A Clinical Perspective

TL;DR

This study examines how spinal anesthesia with morphine or fentanyl affects newborn health, finding better short-term outcomes with morphine, especially in male babies.

Contribution

The study provides new evidence that maternal spinal anesthesia with morphine may improve neonatal outcomes compared to fentanyl.

Findings

Newborns in the morphine group had significantly higher 1-minute Apgar scores than those in the fentanyl group.

Male neonates in the morphine group had higher oxygen saturation compared to those in the fentanyl group.

There were no significant differences in 5-minute Apgar scores or outcomes in female neonates between the groups.

Abstract

Background/Objectives: Spinal anesthesia, frequently used in cesarean deliveries, can have a significant impact on newborns. This study aims to evaluate the effects of spinal anesthesia with morphine or fentanyl as adjuvants on neonatal outcomes. Methods: A retrospective study was conducted over a specific period on 170 newborns delivered via cesarean section at the Pelican Clinic, Medicover Hospital, Romania. The neonatal parameters assessed included Apgar scores at 1 and 5 min, oxygen saturation, respiratory rate, and heart rate in two groups of newborns whose mothers underwent spinal anesthesia with bupivacaine combined with either morphine or fentanyl (group M_n and group F_n). Statistical analysis was performed using IBM SPSS Statistics (version 29.0.2.0 (20)). Results: Newborns in the M_n group had significantly higher Apgar scores at 1 min compared to those in the F_n group (9.63 ± 0.57 vs 9.40 ± 0.65, p = 0.010); however, at 5 min, the scores were comparable between groups. Regarding oxygen saturation, male neonates born to mothers who received morphine had significantly higher values than those in the fentanyl group (96.08 ± 4.14% vs. 94.50 ± 4.36%, p = 0.026), whereas no significant differences were observed in female neonates. Conclusions: The use of morphine in maternal spinal anesthesia may improve immediate neonatal adaptation, particularly in male newborns.

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