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Acta Anaesthesiol Scand - 2025 - Eley - Cesarean Delivery in Queensland Australia A Retrospective Study of Factors205.42 kB
Published VersionCC BY-NC-ND V4.0, Open Access
Journal article
Cesarean Delivery in Queensland, Australia—A Retrospective Study of Factors Associated With Primary and Secondary General Anesthesia
Acta Anaesthesiologica Scandinavica, Vol.69(9), pp.1-11
2025
PMID: 40952129
Abstract
Background
Queensland maternity services are provided by institutions of varying sizes, that are classified according to the Clinical Services Capability Framework. Obesity is more common in more remote areas. We aimed to identify factors associated primary and secondary general anesthesia in Queensland, Australia.
Methods
Data were obtained from the Anaesthesia Benchmarking System and Mater Health Services between January 2019 and July 2022. The Accessibility/Remoteness Index of Australia Plus classification was used to describe remoteness and the institutional Clinical Services Capability Framework level documented. Associations of individual characteristics, cesarean characteristics and remoteness category with the outcomes of primary and secondary GA, were explored using chi-square tests and modelled using binary logistic regression.
Results
Of 35,227 cases, 22,780 (64.7%) resided in major cities with a median (IQR) body mass index of 29.0 kg m−2 (25.0–34.5). Primary general anesthesia occurred in 1562 (4.4%) and secondary general anesthesia in 1336 (3.8%). Primary general anesthesia occurred more commonly in category 1 cesarean (adjusted odds ratio, aOR 31.49, 95% CI 27.00–36.84) and those with a mental health condition (aOR 1.82, 95% CI 1.57–2.10), both p < 0.001. Primary GA occurred less commonly in nulliparous women (aOR 0.56, 95% CI 0.49–0.63, p < 0.001). Secondary general anesthesia was more likely in those with category 1 surgical urgency (aOR 12.62, 95% CI 10.58–15.07), post-partum hemorrhage (aOR 2.74, 95% CI 2.32–3.23), lowest BMI category (aOR 2.13, 95% CI 1.44–3.07), highest BMI category (aOR 1.71, 95% CI 1.41–2.07) and presence of a mental health condition (aOR 1.57, 95% CI 1.35–1.82), all variables p < 0.001. Clinical Services Capability Framework level 4 and 5 institutions cared for significantly more women with body mass index ≥ 40 kg m−2 however more women with body mass index ≥ 40 kg m−2 resided in remote/very remote locations.
Conclusion
Anesthetists may use these results to anticipate secondary general anesthesia or modify primary techniques. Institutions located in remote areas and with fewer resources cared for more women with obesity, with implications for women and healthcare services.
Details
- Title
- Cesarean Delivery in Queensland, Australia—A Retrospective Study of Factors Associated With Primary and Secondary General Anesthesia
- Authors
- Victoria A. Eley (Corresponding Author) - Royal Brisbane and Women's HospitalAnita Pelecanos - QIMR Berghofer Medical Research InstituteSue Lawrence - Mater Health ServicesSuzanne Bertrand - Mater Health ServicesAlka Kothari - Redcliffe HospitalDoogie Whitcombe - The University of QueenslandGuy Godsall - University of the Sunshine Coast, Queensland, School of Health
- Publication details
- Acta Anaesthesiologica Scandinavica, Vol.69(9), pp.1-11
- Publisher
- Wiley-Blackwell Publishing, Inc.
- Date published
- 2025
- DOI
- 10.1111/aas.70093
- ISSN
- 1399-6576; 0001-5172
- PMID
- 40952129
- Copyright note
- © 2025 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
- Grant note
- V.E. (CRF-128-2021) and A.K. (CRF-509-2023) were funded by Metro North Clinician Research Fellowships (CRF-128-2021).
- Organisation Unit
- School of Health
- Language
- English
- Record Identifier
- 991185244502621
- Output Type
- Journal article
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