Impact of Exogenous Factors and Anesthetic Risk in Premature Birth during the Pandemic Period

Abstract

Background: Premature birth remains a public health problem worldwide, involving a broader context and a multidisciplinary team aimed at combating this phenomenon as much as possible. The consumption of addictive substances by women who are pregnant can occur in different social contexts and at different stages of their lives, which modulate its extent. Obstetricians and anesthetists should consider the anesthetic maternal risks that may arise due to these addictive behaviors. The maternal anesthetic risk is higher in women who are pregnant with a medium-level of education, imbalanced nutrition, stress associated with physical or mental activity, affected sleep hygiene, and failed marriages.

Objectives: The objectives of the study refer to analyzing the impact of exogenous factors and the anesthetic risk on premature birth for women who were pregnant during the pandemic period and in women who were pregnant without COVID-19 infection. The authors studied a significant sample of 3588 women who were pregnant without COVID-19 infection, among whom 3291 gave birth at term and 297 gave birth prematurely.

Methods: The methods analyzed consist of studying the specialized literature regarding the impact of exogenous factors and parturient's anesthetic risk on premature birth and identifying the regional risk profile of women who are pregnant in the southeast region of Romania compared to that identified in the specialized literature. In the analytical methods, we used a linear regression to study the incidence of exogenous risk factors on anesthetic risk in women who were pregnant with premature births compared to those with full-term births.

Results: The results confirm the significant impact of exogenous factors on anesthetic risk and the significant impact of anesthetic risk on premature births. The novelty of the study lies in highlighting the modification of the regional exogenous risk profile during the pandemic period in southeast Romania due to unfavorable socio-economic causes and the translation of grade I and II prematurity events to higher frequencies with an increased level of maternal anesthetic risk.

Conclusions: The study findings show that the anesthetic risk is maximized in parturients with a middle school education. Additionally, the anesthetic risk of patients who are pregnant increases with the intensification of smoking adherence and its maintenance throughout the pregnancy at the same intensity. Our study aims to provide a basis for the diversification and development of community intervention programs in the post-COVID-19 era, considering the reshaping of social models and the repositioning of social principles and values. Obstetricians and anesthetists must know and promote family values to harmonize the lives of family members and provide a better life for the mother and child.

Keywords: alcohol; anesthetic risk; premature birth; prematurity; smoking.

Figure 1

Pyramid distribution of anesthetic risk in relation to exogenous factors (Blue: CL, Red: EL, Anesthesias (1: No/2: Yes), Age (1: 12–18 years, 2: 19–39 years, 3: >40 years), ResidentialArea (1: Urban/2: Rural), Studies (1: Gymnasium, 2: High-school studies, 3: Higher education, 4: Without studies, 5: Not specified), SmokingAdherence (1: No/2: Yes), AlcoholAdherence (1: No/2: Yes), AdherenceToVices (1: No/2: Yes). Source: Created by the author using IBM SPSS software 26 version, International Business Machines Corp, Deutschland GmbH D-71137 Ehningen, Germany.