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. 2025 Mar 31;12(4):450.
doi: 10.3390/children12040450.

The Impact of Maternal Spinal Anesthesia on Newborn Out-Comes: A Clinical Perspective

Ramona Celia Moisa  1   2   3 , Nicoleta Negrut  2   4 , Iulia Codruta Macovei  3 , Cristina Aur  3 , Mihai Octavian Botea  1   3 , Paula Bianca Maghiar  2   3 , Cezar Cristian Mihai Moisa  5 , Harrie Toms John  6 , Paula Marian  7
Affiliations

The Impact of Maternal Spinal Anesthesia on Newborn Out-Comes: A Clinical Perspective

Ramona Celia Moisa et al. Children (Basel). .

Abstract

Background/objectives: Spinal anesthesia, frequently used in cesarean deliveries, can have a significant impact on newborns. This study aims to evaluate the effects of spinal anesthesia with morphine or fentanyl as adjuvants on neonatal outcomes.

Methods: A retrospective study was conducted over a specific period on 170 newborns delivered via cesarean section at the Pelican Clinic, Medicover Hospital, Romania. The neonatal parameters assessed included Apgar scores at 1 and 5 min, oxygen saturation, respiratory rate, and heart rate in two groups of newborns whose mothers underwent spinal anesthesia with bupivacaine combined with either morphine or fentanyl (group M_n and group F_n). Statistical analysis was performed using IBM SPSS Statistics (version 29.0.2.0 (20)).

Results: Newborns in the M_n group had significantly higher Apgar scores at 1 min compared to those in the F_n group (9.63 ± 0.57 vs 9.40 ± 0.65, p = 0.010); however, at 5 min, the scores were comparable between groups. Regarding oxygen saturation, male neonates born to mothers who received morphine had significantly higher values than those in the fentanyl group (96.08 ± 4.14% vs. 94.50 ± 4.36%, p = 0.026), whereas no significant differences were observed in female neonates.

Conclusions: The use of morphine in maternal spinal anesthesia may improve immediate neonatal adaptation, particularly in male newborns.

Keywords: Apgar; fentanyl; morphine; spinal anesthesia.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of patient inclusion and data analysis in the study. M_n—newborns from mothers with morphine anesthesia; F_n—newborns from mothers with fentanyl anesthesia; n—number.
Figure 2
Figure 2
Apgar score, according to the type of anesthesia. M_n—newborns from mothers with morphine anesthesia; F_n—newborns from mothers with fentanyl anesthesia; Apgar_1—Apgar score at 1 min after birth; Apgar_5—Apgar score at 5 min after birth.
Figure 3
Figure 3
Effect of ephedrine and anesthesia type on neonatal VR_n and RR_n. (A) Correlation between ephedrine dose and neonatal VR_n. (B) Correlation between ephedrine dose and neonatal RR_n. (C) Comparison of neonatal VR_n between Group M_n and Group F_n. (D) Comparison of neonatal RR_n between Group M_n and Group F_n. Group M_n—group of newborns from mothers with morphine anesthesia; Group F_n—group of newborns from mothers with fentanyl anesthesia; VR_n (bpm)—neonatal ventricular rate (beats per minute); RR_n (brpm)—neonatal respiratory rate (breaths per minute).
Figure 4
Figure 4
Effect of anesthesia type on peripheral capillary oxygen saturation. SpO2n—neonatal peripheral capillary oxygen saturation; Group M_n—group of newborns from mothers with morphine anesthesia; Group F_n—group of newborns from mothers with fentanyl anesthesia.
Figure 5
Figure 5
Oxygen saturation by anesthesia group and sex. SpO2n—neonatal peripheral capillary oxygen saturation; Group M_n—group of newborns from mothers with morphine anesthesia; Group F_n—group of newborns from mothers with fentanyl anesthesia.
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