Effect of Supplemental Oxygen on Apgar Score of Newborns in Pregnant Women Undergone Cesarean Section with Spinal Anesthesia
Authors:   Anesthesia, Critical Care and Pain Management Research Center, Tehran university of medical sciences, Tehran, Iran., Nazari Nima , Shamsi Afzal ,   School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran., Mghames Husam Kareem ,   Fellowship of the Iraqi Medical Board in Anesthesia and Intensive Care. Head of ICU, Al Imam Ali General Hospitals. Lecturer, Al Salam College University. Baghdad, Iraq., Fattah Aymen Othman ,   Department of Anesthesia, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
Published: January 2024

Background: In obstetrics, there have been discussions and changes in procedures surrounding the provision of extra oxygen during cesarean sections performed under spinal anesthesia. Despite its recognized benefits in maintaining maternal cerebral oxygenation, concerns persist about its impact on neonatal health, especially regarding newborn oxygen saturation levels. This gap in understanding the direct effects on immediate neonatal outcomes, particularly Apgar scores, underscores the need for further research. This study aimed to determine the effectiveness of supplement on Apgar scores at one and five minutes post-delivery in newborns of mothers undergoing cesarean sections with spinal anesthesia. Methodology: Through randomized sampling, 100 patients from two hospitals in Iraq were included in this interventional trial. Following approval for research and establishment of inclusion and exclusion criteria, the researcher gathered patient sociodemographic information and average score. The sample is divided into two groups: (50) participants as a study group and (50) participants considered as a control group. With a significance threshold 0.05, the gathered data were examined using descriptive and inferential statistics in Statistical Package for the Social Sciences software version 22. Results: The results demonstrated that the most represented age group in both study and control groups was 25-30 years, and the least represented was 35-40 years. The highest BMI category was 'overweight' in both groups, while 'obese' was the least common. Regarding birth weights, the study group had a higher percentage of normal birth weights than the control group. In APGAR scores after 5 minutes, a significantly higher percentage of newborns in the study group had reassuring scores (7 to 10) compared to the control group. Furthermore, a relevant difference in outcomes was shown by a significant link between the study group and the impact of O2 supplement on APGAR score at (p-value. 0). Sociodemographic factors such as age, education level, occupation, BMI, and gestational age showed no significant correlation with APGAR scores, underscoring the complexity of these factors' influence on neonatal outcomes. Conclusion: The study found that supplemental oxygen positively affects newborns' APGAR scores during Cesarean sections with spinal anesthesia, with the study group showing better scores than the control group. It suggests that improving prenatal care, training in neonatal care, ensuring medical equipment availability, and enhancing obstetric research and education are vital for better neonatal and maternal care in Iraq, ultimately leading to improved health outcomes for mothers and newborns.