Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean section

IntroductionThis study aimed to investigate the impact of maternal type and its interactions on the incidence of hypotension following spinal anesthesia.MethodsIn this retrospective cohort study, both primiparous and multiparous women were included. Demographic, pregnancy-related, and hemodynamic da...

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Main Authors: Jizheng Zhang, Jinli Che, Xiaohua Sun, Yi Li, Wanlu Ren
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1617342/full
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author Jizheng Zhang
Jinli Che
Xiaohua Sun
Yi Li
Wanlu Ren
author_facet Jizheng Zhang
Jinli Che
Xiaohua Sun
Yi Li
Wanlu Ren
author_sort Jizheng Zhang
collection DOAJ
description IntroductionThis study aimed to investigate the impact of maternal type and its interactions on the incidence of hypotension following spinal anesthesia.MethodsIn this retrospective cohort study, both primiparous and multiparous women were included. Demographic, pregnancy-related, and hemodynamic data were collected. Univariate and multivariate logistic regression analyses were performed to evaluate the association between these factors and the occurrence of hypotension after spinal anesthesia. Additionally, multivariate models with and without maternal type were constructed, followed by interaction analysis.ResultsPrimiparous women had a lower median age and slightly greater weight gain during pregnancy compared to multiparous women. They also exhibited significantly higher pleth variability index (PVI) and heart rate (HR), while heart rate variability (HRV) was significantly lower. Univariate regression analysis identified maternal type, age, weight gain during pregnancy, estimated fetal weight, PVI, HR, HRV, and systolic blood pressure (SBP) as significant predictors of hypotension. Multivariate model analysis showed that adding the variable of parity significantly improved the model’s ability to discriminate the occurrence of hypotension (Model 2 AUC = 0.815 vs. Model 1 AUC = 0.740). Interaction analysis revealed significant interactions between heart rate variability (HRV), systolic blood pressure (SBP), gestational weight gain, and parity, suggesting that these physiological characteristics are more strongly associated with hypotension in primiparas.DiscussionIn conclusion, primiparous women are at significantly higher risk of developing hypotension after spinal anesthesia than multiparous women. Baseline perfusion index (PI), estimated fetal weight, and baseline PVI are key contributing factors to this outcome.
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spelling doaj-art-9f99e4bce47648b0927148f79c3fe2892025-08-20T02:35:50ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-06-011210.3389/fsurg.2025.16173421617342Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean sectionJizheng ZhangJinli CheXiaohua SunYi LiWanlu RenIntroductionThis study aimed to investigate the impact of maternal type and its interactions on the incidence of hypotension following spinal anesthesia.MethodsIn this retrospective cohort study, both primiparous and multiparous women were included. Demographic, pregnancy-related, and hemodynamic data were collected. Univariate and multivariate logistic regression analyses were performed to evaluate the association between these factors and the occurrence of hypotension after spinal anesthesia. Additionally, multivariate models with and without maternal type were constructed, followed by interaction analysis.ResultsPrimiparous women had a lower median age and slightly greater weight gain during pregnancy compared to multiparous women. They also exhibited significantly higher pleth variability index (PVI) and heart rate (HR), while heart rate variability (HRV) was significantly lower. Univariate regression analysis identified maternal type, age, weight gain during pregnancy, estimated fetal weight, PVI, HR, HRV, and systolic blood pressure (SBP) as significant predictors of hypotension. Multivariate model analysis showed that adding the variable of parity significantly improved the model’s ability to discriminate the occurrence of hypotension (Model 2 AUC = 0.815 vs. Model 1 AUC = 0.740). Interaction analysis revealed significant interactions between heart rate variability (HRV), systolic blood pressure (SBP), gestational weight gain, and parity, suggesting that these physiological characteristics are more strongly associated with hypotension in primiparas.DiscussionIn conclusion, primiparous women are at significantly higher risk of developing hypotension after spinal anesthesia than multiparous women. Baseline perfusion index (PI), estimated fetal weight, and baseline PVI are key contributing factors to this outcome.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1617342/fullcesarean sectionhypotensioninteractionmultiparasprimiparasspinal anesthesia
spellingShingle Jizheng Zhang
Jinli Che
Xiaohua Sun
Yi Li
Wanlu Ren
Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean section
Frontiers in Surgery
cesarean section
hypotension
interaction
multiparas
primiparas
spinal anesthesia
title Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean section
title_full Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean section
title_fullStr Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean section
title_full_unstemmed Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean section
title_short Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean section
title_sort analysis of the risk difference in post spinal anesthesia hypotension between primiparas and multiparas in cesarean section
topic cesarean section
hypotension
interaction
multiparas
primiparas
spinal anesthesia
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1617342/full
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