Impact of intraoperative spinal induced maternal hypotension on neonatal adverse outcome during cesarean section at resource limited area: A prospective observational cohort study

Maternal hypotension is often reported to occur after cesarean section for multiple reasons. However, the effects of intraoperative spine-induced hypotension on neonatal adverse outcomes during cesarean section have not been adequately investigated in sub-Saharan countries, including Ethiopia. This study aimed to investigate the effect of intraoperative spinal-induced hypotension on neonatal adverse outcomes during cesarean section. This research carried out a prospective cohort study from May 15–August 15, 2023. We selected 202 mothers via a convenience sampling method. We collected data via a structured interviewer-administered questionnaire. Once we ensured the completeness and consistency of the collected data, we proceeded to enter it into Epidata 4.6. We subsequently exported the data to SPSS version 25 for analysis. Descriptive statistics were used to summarize the data. Binary logistic regression analysis was used to determine the relative risk between neonatal outcome and maternal hypotension and other related features. By using a confidence interval and p value<0.05, the researchers determined the level of significance. In this study, a total of 202 participants were given a response rate of 100%. The incidence of adverse early neonatal outcomes was 13.4%. Maternal hypotension at the 5-minute ARR (ARR: 3.9, 95% CI: 1.26, 12.2), APGAR score at one minute (ARR: 4.9, 95% CI: 1.7, 14.1)), parity (AOR: 4.2, 95% CI: 1.3, 13.5%), age of the mothers (AOR: 5.1, 95% CI: 1.3, 19.5)), and birth weight (AOR: 3.6, 95% CI: 1.18, 10.9)) were identified as predictors of adverse early neonatal outcomes. In this study, the incidence of adverse neonatal outcomes was high. To reduce maternal hypotension after anesthesia, monitoring vital signs should be strengthened. To increase the birth interval, it is necessary to expand family planning. Screening during the antenatal and intrapartum periods should be promoted to reduce poor maternal health conditions, and proper nutrition should be provided to reduce birth weight.