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Anaesthetics
Original article
Intrapartum intravenous fluids for caesarean delivery and newborn weight loss: a retrospective cohort study
  1. Sherif Eltonsy1,2,
  2. Alain Blinn3,4,
  3. Brigitte Sonier5,
  4. Steven DeRoche3,4,
  5. Aubin Mulaja3,4,
  6. William Hynes3,4,
  7. André Barrieau3,4,
  8. Mathieu Belanger1,3,4,5
  1. 1 Centre de formation médicale du Nouveau-Brunswick, Moncton, Canada
  2. 2 The Maritime SPOR SUPPORT Unit (MSSU), Moncton, Canada
  3. 3 Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Canada
  4. 4 Dieppe Family Medicine Unit, Dieppe, Canada
  5. 5 Research Centre, Vitalité Health Network, Moncton, Canada
  1. Correspondence to Dr Mathieu Belanger; mathieu.f.belanger{at}usherbrooke.ca

Abstract

Objective To examine weight loss (WL) and excess weight loss (EWL) among newborns of caesarean delivery, comparing colloids plus crystalloids versus crystalloids only. Also, to examine different doses of intrapartum intravenous fluids on WL and EWL.

Design Comparative safety retrospective cohort study.

Setting University Teaching Hospital, Moncton, Canada.

Patients Mothers exposed to intravenous fluids with caesarean delivery between 2008 and 2016.

Interventions Exposure to colloids plus crystalloids was compared with crystalloids only, and dose-response analyses were performed for colloids, crystalloids and total intravenous fluids doses. Linear and logistic regression models were used, adjusting for potential confounders.

Main outcome measures Infants’ WL was measured at days 1, 2 and 3 post partum, and EWL defined as loss of >7% of birth weight.

Results From 801 mother-infant pairs, 176 were exposed to colloids plus crystalloids and 625 were exposed to crystalloids only (overall mean birth weight=3416 g, EWL=2%, 41.4% and 55.5% on days 1, 2 and 3, respectively). No significant difference in newborns’ WL was observed on any of the days assessed. Adjusted OR (95% CI) of EWL was 1.0 (0.3 to 3.3) at 24 hours, 1.0 (0.7 to 1.5) at 48 hours and 1.4 (0.9 to 2.2) at 72 hours. No dose-response relationship was detected with type-specific and total intravenous fluids exposures.

Conclusions The risk of EWL was similar with colloids plus crystalloids and crystalloids only, suggesting that both therapeutic options can be considered during caesarean delivery. The absence of dose-response relationships adds confirmatory evidence to the intravenous fluids safety profiles.

  • birth weight
  • weight loss
  • colloids
  • crystalloids
  • caesarean section

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjpo-2017-000070

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    Footnotes

    • Contributors SE, ABa, BS, SD, AM, WH, ABl and MB have contributed to the concept and design of the study. SE and MB performed the analysis and drafted the first draft. SE, ABa, BS, SD, AM, WH, ABl and MB participated in the interpretation of the data. SE, ABa, BS, SD, AM, WH, ABl and MB contributed in drafting and revising of the full manuscript, and have approved the manuscript as submitted. SE, ABa, BS, SD, AM, WH, ABl and MB have met the criteria of authorship, and take public responsibility for the study contents.

    • Competing interests None declared.

    • Ethics approval Research Ethics Committee of the Vitalité Health Network.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data are available after discussion with the corresponding author in accordance with our data-sharing policy.