Factors Affecting Maternal and Fetal Outcomes of Non-Obstetric Surgery and Anesthesia during Pregnancy: a Retrospective Review of Data at a Single Tertiary University Hospital.

BACKGROUND

Anesthesia during pregnancy for non-obstetric surgery is generally known to have a negative impact on maternal and fetal outcomes. We assessed the risk of adverse outcomes in fetuses and mothers associated with non-obstetric surgery.

METHODS

This retrospective study analyzed clinical data on pregnant women who received non-obstetric surgeries at a tertiary university hospital. We reviewed maternity admissions using hospital administrative data during the last 16 years. The outcome assessment included the presence of preterm labor, premature birth, abortion, or stillbirth and the data of newborns. Statistical analyses were performed using the t-test, χ² test, and multiple logistic regression was used for risk analysis.

RESULTS

The incidence of non-obstetric surgery during pregnancy was 0.96%. Gestational age at or above 20 weeks increased the risk of all adverse events 4.5 fold when it was compared to gestational age less than 20 weeks, although the events were only preterm labor or premature birth and no fetal loss. All fetal loss cases occurred in patients at less than 20 weeks of pregnancy. The risk of adverse outcome increased by 2% for every 1 minute increase in anesthesia time. Babies of the mothers who had the adverse outcome event showed lower birth weight and higher neonatal intensive care unit admission rate than those of babies of the mothers without any adverse event after the surgery.

CONCLUSION

Physicians should acknowledge and prepare for common possible adverse events at the stage of pregnancy after non-obstetric surgery, and effort to shorten the duration of surgery and anesthesia is needed.