Neonatal Bilirubin Assessment After Implementation of Enhanced Recovery After Caesarean Section

The implementation of Enhanced Recovery After Cesarean (ERAC) is associated with significant improvement in maternal outcomes; however, its impact on neonatal outcomes remains limited. This study aims to evaluate the impact of ERAC protocol on neonatal outcomes.

A retrospective cross-sectional study was conducted at Bunda Women and Children Hospital, Jakarta, Indonesia between 2021 and 2022 on women who performed cesarean delivery at 37 weeks and above. The primary outcome was neonatal bilirubin level and the secondary outcome was neonatal length of stay and breastfeeding rate.

Differences between outcomes were analyzed by comparing each parameter in non-ERAC (n = 356) and the ERAC groups (n = 331). The median bilirubin levels and neonatal length of stay did not exhibit significant differences between the non-ERAC and the ERAC group (9.5 mg/dL vs 9.5 mg/dL, P = .545, for bilirubin levels, and 3 days vs 3 days, P = .060 for neonatal length of stay). However, the ERAC group demonstrated a significantly higher breastfeeding rate compared to the non-ERAC group (3 hours vs 5 hours, P < .001, respectively).

The implementation of the ERAC protocol does not influence neonatal bilirubin levels and the length of neonatal hospital stays but it increases breastfeeding rate.