ORIGINAL RESEARCH article
Front. Surg.
Sec. Obstetrics and Gynecological Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1617342
Analysis of the Risk Difference in Post-Spinal Anesthesia Hypotension Between Primiparas and Multiparas in Cesarean Section
Provisionally accepted
- Tianjin Hospital Affiliated to Tianjin University, Tianjin, China
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This study aimed to investigate the impact of maternal type and its interactions on the incidence of hypotension following spinal anesthesia. In 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. Primiparous 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. In 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.
Keywords: Cesarean Section, Hypotension, Interaction, Multiparas, Primiparas, spinal anesthesia
Received: 24 Apr 2025; Accepted: 02 Jun 2025.
Copyright: © 2025 Zhang, Che, Sun, Li and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wanlu Ren, Tianjin Hospital Affiliated to Tianjin University, Tianjin, China
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