Data from: Short-term maternal and neonatal outcomes in preterm (< 33 weeks gestation) Cesarean deliveries under general anesthesia with deferred cord clamping

Deferred cord clamping (DCC) is beneficial for preterm infants, but there
are concerns about the safety of DCC during Cesarean deliveries (CD) under
general anesthesia (GA). We evaluated maternal and neonatal outcomes in
preterm CD under GA vs. regional anesthesia (RA) after implementing 180 s
of DCC. This retrospective single-center observational study included CD
at < 33 weeks of gestation, delivered between January 2018 and
December 2023. The cord was clamped before 180 s for concerns of maternal
bleeding or infant apnea after 30-45 s stimulation. Multivariable
regression analysis was used to assess the effect of anesthesia type and
DCC on outcomes, adjusting for confounders. This study included 170
mothers and 194 infants, 84.9 % of the infants received DCC ≥ 60
s. The GA group had higher emergency CD and lower median duration
of DCC (105 s vs 180 s, p = <0.001) compared to RA. GA was
associated with lower odds (95 % CI) of UA pH < 7 [0.1, (0.0,
0.6)], base deficit ≥ 16 [0.0, (0.0, 0.5)], and higher odds of NEC [28.2,
(1.4, 560.0)]. DCC ≥ 60 seconds was associated with lower maternal blood
loss [Regression coefficient -698, (-1193, -202)], lower odds of
transfusion [0.4, (0.1, 1.0)], DR resuscitation [0.4, (0.2, 0.8)], chronic
lung disease [0.4, (0.2, 0.9)], and higher survival without major
morbidities [2.8, (1.2, 6.8)]. DCC can be safely accomplished in
majority of CD under GA with protocols to shorten DCC in cases where
maternal or fetal safety is threatened. GA with DCC was not associated
with increased neonatal resuscitation or major NICU morbidities and was
associated with lower maternal hemorrhage and transfusion.