Can anesthesiologic strategies for caesarean section influence newborn jaundice? A retrospective and prospective study

Rationale and Objectives: Neonatal jaundice is a frequent problem in neonat ology and can be influenced by many factors. Our study arose from the clini cal observation that among all newborns delivered by caesarean section in o ur center, some had a more intense physiological jaundice. We began by revi ewing clinical anesthesiological case-sheets to ascertain whether this diff erence was linked to the use of different anesthesiologic strategies. We th en performed a prospective study on healthy preterm and term newborns to ve rify this hypothesis. Study Design: We retrospectively considered all healt hy term newborns with weight >2,400 g delivered by caesarean section from J anuary 1998 to May 1999, In the prospective studies we included healthy ter m and preterm newborns consecutively delivered by caesarean section from Ma y 1999 to December 1999. We excluded preterm newborns with gestational age <31 weeks and with weight <1,400 g. Results: Both in retrospective and in p rospective studies anesthetic agents employed were isoflurane (A), sevoflur ane (B), or bupivacaine (C). The statistical comparison of the three groups in retrospective study confirmed the clinical observation: the total bilir ubin levels were significantly higher in the isoflurane group than in the s evoflurane group (p = 0.0000) and bupivacaine group (p = 0.0002). Analysis of data from the prospective study on term newborns confirmed our previous results. In preterm infants total bilirubin is statistically higher in grou p A starting from 96 h postdelivery. Conclusions: It is likely that anesthe tic technique can be included among factors with possible influence on neon atal jaundice. Copyright (C) 2001 S. Karger AG, Basel.