Prophylactic phenylephrine infusion versus treatment with vasopressor bolus as needed during non-urgent cesarean delivery and neonatal acidemia: a retrospective cohort study (2016–2021)
Authors' conclusion
In this pragmatic study, prophylactic phenylephrine infusion was associated with a reduction in maternal spinal hypotension, but not reduced neonatal acidemia.
Study context
- Population
- Non-urgent cesarean delivery under spinal anesthesia (2016 to 2021)included in final analysis
- Participants
- 4,392 participants
- Exposure
- Prophylactic phenylephrine infusion vs phenylephrine boluses as needed
- Prophylactic phenylephrinen = 1,318
- Outcome
- Neonatal acidemia (umbilical artery pH < 7.1)
Methodological detailspragmatic
- Pragmatic
Main finding
As reported in the abstract
Adjusted odds ratio
0.83
95% CI 0.52–1.33
P = 0.435
Events by group
Prophylactic phenylephrine vs Boluses as needed
aOR 0.83 (95% CI 0.52–1.33); P = 0.435
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Maternal spinal hypotension (SBP < 100 mmHg) | 0.47 (0.37–0.57) | P < 0.001 | |
| 0.20.5125Odds ratio (log scale) |
Maternal spinal hypotension (systolic blood pressure (SBP) < 100 mmHg)
- Similar results when hypotension defined as drop below 80% or 90% of baseline SBP
Original publication
Prophylactic phenylephrine infusion versus treatment with vasopressor bolus as needed during non-urgent cesarean delivery and neonatal acidemia: a retrospective cohort study (2016–2021). Int J Obstet Anesth. Published 22 August 2024. doi:10.
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