Evidence map›Paper›PMID 37106343›Full record

Trial reportBMC anesthesiology2023

Effect of anesthesia administration method on apgar scores of infants born to women undergoing elective cesarean section.

Chipo Gwanzura, Samuel Gavi, Marcia Mangiza, Faith Vhenekai Moyo, Matthew C Lohman, Taazadza Nhemachena, Tsungai Chipato

Registry-linked trialAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04733157 (The Efficacy of Tranexamic Acid in Preventing Postpartum Haemorrhage After Caesarean Section), which is not on this map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04733157 phase3completednot on this map

The Efficacy of Tranexamic Acid in Preventing Postpartum Haemorrhage After Caesarean Section

TypeinterventionalSponsorUniversity of ZimbabweRan2021 to 2021Enrolled1,226ConditionsPostpartum HemorrhageArmsTranexamic acid injection, Normal saline placebo
3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Article
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  4. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Chipo GwanzuraDepartment of Obstetrics and Gynecology, Faculty of Medicine and Health Science, University of Zimbabwe, Harare, Zimbabwe.
Samuel GaviDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA. sgavi@email.sc.edu.
Marcia MangizaDepartment of Pediatrics, Faculty of Medicine and Health Science, University of Zimbabwe, Harare, Zimbabwe.
Faith Vhenekai MoyoDepartment of Anesthesia and Critical Care Medicine, Sally Mugabe Central Hospital, PO Box ST14 Southerton, Harare, Zimbabwe.
Matthew C LohmanDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.
Taazadza NhemachenaDepartment of Obstetrics and Gynecology, Faculty of Medicine and Health Science, University of Zimbabwe, Harare, Zimbabwe.
Tsungai ChipatoDepartment of Obstetrics and Gynecology, Faculty of Medicine and Health Science, University of Zimbabwe, Harare, Zimbabwe.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeonatal health at delivery as measured by apgar scores is an important outcome. This study was done to assess the impact of anesthesia on Apgar 1-minute and 5-minute scores of infants delivered through elective cesarean section in Zimbabwe.

methodsWe carried out a secondary analysis of data from the Efficacy of Tranexamic Acid in Preventing Postpartum Hemorrhage (ETAPPH) clinical trial in Zimbabwe. Outcomes measured were infant Apgar scores at 1 and 5 min, exposure was the administration of either a general (intravenous propofol/ketamine/sodium thiopental) or spinal (hyperbaric bupivacaine 0.5%) anesthesia for anesthesia during the elective cesarean section procedure. Marginal Structural Logistic Modelling (MSM) using an unstabilized Inverse Probability Treatment Weight (IPTW) estimator was used to assess the relationship between anesthetic administration method and infant Apgar scores.

resultsFour hundred and twenty-one (421) women who had an elective caesarean section in the ETAPPH study had their infants assessed for Apgar scores. Comparing general anesthesia to spinal anesthesia, spinal anesthesia was related to good Apgar scores at 1-minute (adjusted odds ratio [aOR] = 4.0, 95% Confidence Interval = 1.5-10.7, sensitivity analysis E-value = 3.41). Spinal anesthetic administration was also related to good Apgar scores at 5 min (adjusted odds ratio [aOR] = 6.2, 95% Confidence Interval = 1.6-23.1, sensitivity analysis E-value = 4.42).

conclusionsWhen providing anesthesia for patients undergoing elective cesarean section, care should be taken on the method of administration of anesthetic agents. General anesthesia tends to depress Apgar scores at 1 min, although most neonates recover and have better scores at 5 min. Spinal anesthesia should be the first choice whenever possible.

trial registrationThe clinical trial from which data of this study was abstracted was registered under clinical trials registration number NCT04733157.

Indexed as

Anesthesia, ObstetricalAnesthesia, SpinalPropofolApgar ScoreCesarean SectionFemaleHumansInfantInfant, NewbornParturitionPregnancyPropofolApgar scoresElective cesarean sectionGeneral anesthesiaMarginal structural logistic modellingSpinal anesthesia

Identifiers

PMID37106343
PMCPMC10134612

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.