Anaesthetic exposure during oocyte pickup: Comparative effects of fentanyl-propofol versus parecoxib sodium on neonatal outcomes

Objective: To evaluate the neonatal outcomes of fentanyl-propofol anaesthesia versus parecoxib sodium analgesia regimens used during oocyte pickup (OPU). Methods: Couples who underwent assisted reproductive technology (ART) treatment at the Reproductive Genetics Department of the First Affiliated Hospital of Kunming Medical University from April 2016 to February 2022 were enrolled in this study. The participants were divided into two groups based on the anaesthesia protocols used during OPU: parecoxib sodium analgesia ( n =1 124) and fentanyl-propofol anaesthesia ( n =1 190). Neonatal outcomes were systematically compared between these groups, with infant birth weight as the primary outcome. Results: A total of 2 314 couples were included in the study. After adjustment for confounders, the median birth weight of infants was significantly lower in the parecoxib sodium group than in the fentanyl-propofol group [3100 g (interquartile range: 2850-3400) vs 3200 g (IQR: 2900-3450), adjusted β= -50.9 (95% CI: -89.4 to -12.3), P =0.01]. This weight difference remained particularly significant in male infants [3120 g vs 3200 g, β= -63.4 (95% CI: -119.2 to -7.5), P =0.03], whereas no significant difference was observed in female infants after adjustment [β= -27.9 (95% CI: -82.9 to 27.1), P >0.05]. Conclusion: Neonates born after OPU with parecoxib sodium weighed significantly less than those delivered under fentanyl- propofol, and this difference was confined to male infants.