The Type of Anesthesia Used during Cesarean Section Is Related to the Transient Tachypnea of the Newborn

Aim. To demonstrate whether transient tachypnea of the newborn (TTN) is found more frequently in women undergoing general or combined epidural-spinal (CES) anesthesia during Cesarean section. Methods. This study was done retrospectively. A total of 1447 Cesarean sections (C/S) were performed in our clinic between January 2008 and December 2011. General anesthesia was performed in 1078 (74.5%) of the Cesarean cases. CES anesthesia was performed in 369 cases (25.5%). The International Classification of Diseases,Tenth Revision code of P22.1, was used to identify the infants with TTN. Stratified multivariate analysis was undertaken on subgroups to assess the effect modification by factors known to influence the incidence of TTN: maternal age, maternal systolic-diastolic artery pressure, heart rate, Apgar score at 1 and 5 minutes, sex, time interval from spinal block to skin incision, and time interval from skin incision to umbilical cord clamping. Results. The rate of TTN diagnosis was found to be higher in parturients who had a cesarean section with combined epidural-spinal anesthesia, but no statistical differences were found. (odds ratio = 1.471 and 95%CI: 0.92–2.35). Conclusions. The incidence of TTN was found related to C/S but independent from the type of anesthesia. However, studies with a wider spectrum of patients and a lower quantitative difference between the groups are needed in order to draw firm this conclusions. 1. Introduction TTN is the most common cause of respiratory distress in newborns [1]. It is defined as respiratory distress thought to arise from a delay in fetal lung fluid absorption; it appears within the first six hours after delivery and resolves spontaneously with supportive therapy within a couple of days. The pathophysiology of transient tachypnea of the newborn (TTN) has not been fully explained. Potential factors include lack of exposure to the increased effect of catecholamines and other hormones in deliveries, which are initiated before the labor begins and insufficient activity of amiloride-sensitive epithelial sodium channels (ENaCs) [2–7]. Other potential risk factors such as negative amniotic fluid phosphatidylglycerol, Apgar score < 7, male gender, and failure to evacuate fetal lung fluid due to insufficient pressure in the thorax related to cesarean section (C/S) delivery have been reported for TTN [8]. Cesarean is derived from the Latin verb “caedere” meaning “to cut”. It was first used in 700 BC during the Roman era in order to remove a baby from the womb of a mother who died during childbirth during advanced