# 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.

## Key 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.