Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Perinat Med. 2020 Jun 25;48(5):463-470. doi: 10.1515/jpm-2019-0412.
Background Mother-infant bonding is an emerging perinatal issue. While emergency cesarean deliveries are associated with a risk of bonding disorders, the mode of anesthesia used for emergency cesarean deliveries has never been studied in this context. We aimed to investigate the impact of administering general anesthesia and neuraxial anesthesia to women undergoing cesarean deliveries on mother-infant bonding. Methods This was a retrospective, propensity score-matched multivariable analysis of 457 patients who underwent emergency cesarean deliveries between February 2016 and January 2019 at a single teaching hospital in Japan. The Mother-Infant Bonding Scale (MIBS) scores at hospital discharge and the 1-month postpartum outpatient visit were evaluated in the general anesthesia and the neuraxial anesthesia groups. A high score on the MIBS indicates impaired mother-infant bonding. Results The primary outcome was the MIBS score at hospital discharge in propensity score-matched women. After propensity score matching, the median [interquartile range (IQR)] MIBS scores were significantly higher in the general anesthesia group than those in the neuraxial anesthesia group at hospital discharge [2 (1-4) vs. 2 (0-2); P = 0.015] and at the 1-month postpartum outpatient visit [1 (1-3) vs. 1 (0-2); P = 0.046]. In linear regression analysis of matched populations, general anesthesia showed a significant and positive association with the MIBS scores at hospital discharge [beta coefficient 0.867 (95% confidence interval [CI] 0.147-1.59); P = 0.019] but not at the 1-month postpartum outpatient visit [0.455 (-0.134 to 1.044); P = 0.129]. Conclusion General anesthesia for emergency cesarean delivery is an independent risk factor associated with impaired mother-infant bonding.
母婴结合是一个新兴的围产期问题。虽然紧急剖宫产与母婴结合障碍的风险相关，但用于紧急剖宫产的麻醉方式在这种情况下从未被研究过。我们旨在研究对接受剖宫产的妇女进行全身麻醉和脊麻对母婴结合的影响。
这是一项回顾性、倾向评分匹配的多变量分析，纳入了 2016 年 2 月至 2019 年 1 月期间在日本一家教学医院接受紧急剖宫产的 457 名患者。在出院时和产后 1 个月的门诊评估全身麻醉组和脊麻组的母婴结合量表（MIBS）评分。MIBS 评分高表明母婴结合受损。
主要结局是倾向评分匹配女性出院时的 MIBS 评分。在倾向评分匹配后，全身麻醉组出院时的 MIBS 中位数（四分位距 [IQR]）显著高于脊麻组[2（1-4）比 2（0-2）；P=0.015]和产后 1 个月门诊时[1（1-3）比 1（0-2）；P=0.046]。在匹配人群的线性回归分析中，全身麻醉与出院时的 MIBS 评分呈显著正相关[β系数 0.867（95%置信区间 [CI] 0.147-1.59）；P=0.019]，但与产后 1 个月门诊时的 MIBS 评分无相关性[0.455（-0.134 至 1.044）；P=0.129]。
紧急剖宫产时使用全身麻醉是母婴结合受损的独立危险因素。
