Table 4.
Factors associated with hypotension after spinal anesthesia in univariable and multivariable analyse among C/S patients admitted to the hospital in mogadishu, Somalia 2024, (n = 320)
| Variables | OR (95%CI) | P-value | AOR (95%CI) | P-value |
|---|---|---|---|---|
| Age (Years) | ||||
| Less than or equal 20 | 1 | |||
| 21–35 | 1.88 (0.88–4.04) | 0.105 | ||
| > 35 | 3.21 (1.11–9.26) | 0.031 | ||
| BMI (Kg/M 2 ) | ||||
| Less than or equal 25 | 1 | 1 | ||
| > 25 | 1.84 (1.07–3.16) | 0.027 | 2.65 (1.39–5.04) | 0.003 |
| Pregnancy type | ||||
| Singleton | 1 | |||
| Twins | 0.49 (0.18–1.38) | 0.177 | ||
| Surgery type | ||||
| Emergency | 0.76 (0.44–1.32) | 0.325 | ||
| Elective | 1 | |||
| Gravidity | ||||
| 1 | 1 | |||
| 2 | 0.68 (0.32–1.46) | 0.322 | ||
| 3–4 | 1.31 (0.60–2.87) | 0.494 | ||
| Greater than or equal 5 | 1.30 (0.52–3.26) | 0.576 | ||
| Previous cesarean section | ||||
| Yes | 1.91 (1.07–3.42) | 0.030 | ||
| No | 1 | |||
| History hypertension in pregnancy | ||||
| Yes | 1 | 1 | ||
| No | 5.45 (2.62–11.32) | < 0.001 | 6.00 (2.50–14.40) | < 0.001 |
| Baseline systolic blood pressure | ||||
| Less than or equal 120 | 4.53 (2.24–9.16) | < 0.001 | ||
| > 120 | 1 | |||
| Baseline heart rate (bpm) | ||||
| Less than or equal 100 | 1 | |||
| > 100 | 0.69 (0.25–1.83) | 0.445 | ||
| Fasting duration (hours) | ||||
| Yes | 1 | |||
| No | 1.24 (0.65–2.34)1 | 0.516 | ||
| BP prior induction | ||||
| Normal Bp | 1 | |||
| Low Bp | 1.45 (0.32–6.65) | 0.629 | ||
| High Bp | 0.21 (0.10–0.43) | < 0.001 | ||
| Preload | ||||
| Yes | 1 | 1 | ||
| No | 1.91 (0.94–3.84) | 0.072 | 3.06 (1.22–7.66) | 0.017 |
| Volume of preload (ml) | ||||
| Less than or equal 500 | 0.60 (0.16–2.21) | 0.439 | ||
| > 500 | 1 | |||
| Duration of preload (min) | ||||
| Less than or equal 5 | 1.89 (0.43–8.30) | 0.400 | ||
| > 5 | 1 | |||
| None | 2.07 (0.67–6.42) | 0.206 | ||
| Patient positioning after spinal | ||||
| Leg wrapping | 0.71 (0.14–3.74) | 0.686 | ||
| Left lateral table tilt | 2.56 (0.32–20.53) | 0.378 | ||
| None | 1 | |||
| Interspace at which SAB was administered | ||||
| L3-L4 | 1 | |||
| L4-L5 | 1.97 (1.15–3.38) | 0.014 | ||
| Metoclopramide medication | ||||
| Yes | 1 | |||
| No | 1.95 (1.00-3.80) | 0.050 | ||
| Ephedrine medication | ||||
| Yes | 1 | 1 | ||
| No | 6.75 (3.56–12.80) | < 0.001 | 8.84 (4.10-19.05) | < 0.001 |
| Phenylephrine medication | ||||
| Yes | 1 | |||
| No | 1.04 (0.53–2.06) | 0.913 | ||
| Interval between spinal induction and skin incision (min) | ||||
| 5–6 | 1 | |||
| > 6 | 2.48 (0.56–11.01) | 0.232 | ||
| Amount of crystalloid intraoperative (ML) | ||||
| 1000 | 3.70 (1.63–8.38) | 0.002 | ||
| 1000–1500 | 2.37 (1.11–5.03) | 0.025 | ||
| > 1500 | 1 | |||
| Preoperative hemoglobin | ||||
| Above 11 g/dl | 1 | 1 | ||
| Below 11 g/dl | 3.07 (1.65–5.73) | < 0.001 | 2.52 (1.25–5.05) | 0.010 |
| Indication for C/S | ||||
| Malpresentation | 1 | |||
| Non-reassuring fetal status | 0.73 (0.36–1.51) | 0.400 | ||
| Previous scar | 1.49 (0.65–3.39) | 0.346 | ||
| Uterine rapture | 0.65 (0.12–3.55) | 0.621 | ||
| Pregnancy-related high blood pressure disorders | 0.15 (0.06–0.39) | < 0.001 |
1 = Reference
The significance (bold) level was set at α = 0.05