Is Maternal Anemia Associated With Hypotension During a Scheduled Cesarean Delivery? [A180]. (May 2022)

• Record Type: Journal Article
• Authors: Bharucha, Jinai; Rimsza, Rebecca; Palanisamy, Arvind; Raghuraman, Nandini; Bligard, Katherine H.
• Is Part Of: Obstetrics and gynecology. Volume 139(2022)Supplement 1
• Page Start: 52S
• Page End: 52S
• Publication Date: 2022-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000825996.57745.4e
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Hypotension is the most common complication of anesthesia during cesarean delivery (CD) and is associated with both maternal and neonatal morbidity. Maternal anemia presents additional cardiovascular stress, which could compromise the reserve available to overcome the vasodilation associated with spinal anesthesia. We investigated whether maternal anemia predisposes patients to spinal-related hypotension. METHODS: We performed an institutional review board‒approved retrospective cohort study including all women delivering non-anomalous, term singletons via scheduled CD under spinal anesthesia from 2004 to 2014 at a tertiary-care center. Anemia was defined as admission hemoglobin <11 g/dL. The primary outcome was intraoperative hypotension, defined as 30% decrease in systolic blood pressure (SBP) from baseline or SBP<90 mmHg, and was compared between anemic and non-anemic patients. Multivariable logistic regression was used to adjust for confounders. Prophylactic vasopressor infusion was not a standard of care during the study period. RESULTS: Of 1, 988 patients included, 742 (37%) had anemia. Anemic patients were younger and less likely to be nulliparous or to have gestational diabetes ( P <.01 for all). Incidence of intraoperative hypotension was greater in non-anemic patients (52.0% versus 45.8%; P <.01). However, after adjusting for known risk factors for spinal-related hypotension, the risk of hypotension in anemic patients was similar to that in non-anemia patients (aOR, 0.79; 95% CI, 0.59–1.05). CONCLUSION: Maternal anemia is not associated with hypotension during scheduled CD. These findings argue against the need for additional measures to prevent intraoperative hypotension in anemic patients.