Neonatal Outcomes with Regional versus General Anesthesia for Cesarean Delivery: A Meta-analysis of Randomized Controlled Trials
Authors' conclusion
Regional anesthesia for cesarean delivery is associated with slightly higher Apgar scores and less frequent need for neonatal respiratory support than general anesthesia.
Study context
- Population
- Neonates born by cesarean delivery under regional or general anesthesia, RCTs January 1994 to November 2023
- Participants
- 3,456 neonates · 36 studies
- Comparison
- RA vs GA for cesarean delivery
- Regional anesthesian = 1,980
- General anesthesian = 1,476reference
- Outcome
- Neonatal outcomes: Apgar score at 1 and 5 min, need for respiratory support, need for neonatal intensive care
Methodological detailsrandom effects models, Cochrane Risk of Bias 2, All studies had high or unclear risk of bias
- Random effects models
- Cochrane Risk of Bias 2
- All studies had high or unclear risk of bias
Pooled result
As reported in the abstract
Apgar score
Regional anesthesia vs General anesthesiaMean difference, points (95% CI)P value
At 1 min
0.58(0.36–0.79)
P < 0.001At 5 min
0.09(0.05–0.13)
P < 0.001Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Respiratory support after deliveryLess often required with regional anesthesia | 0.62 (0.40–0.94) | P = 0.03 | |
| 0.512Relative risk (log scale) |
Need for neonatal intensive care
- Did not differ across techniques (RR 0.75; 95% CI 0.46 to 1.21; P = 0.24)
Original publication
Neonatal Outcomes with Regional versus General Anesthesia for Cesarean Delivery: A Meta-analysis of Randomized Controlled Trials. Anesthesiology. Published 6 October 2025. doi:10.
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