Objective To evaluate whether there is a difference in immediate neonatal outcomes with general anesthesia (GA) vs. regional anesthesia (RA) when induction of anesthesia to delivery time (IADT) is prolonged (≥10 minutes). Methods This is a retrospective case-control study that included cases from July 2014 until August 2020. We reviewed all singleton pregnancies delivered between 24 and 42 weeks of gestation with IADT ≥ 10 minutes. The propensity score (PS) matching method was performed using baseline characteristics. Analyses were performed with SAS software version 9.4. Results During the study period, we identified 258 cases meeting inclusion criteria. After the PS matching was applied, the study sample was reduced to 60 cases in each group. The median IADT was similar between groups [41.5m (30.5,52) vs. 46m (38-53.5), p=0.2]. There was no significant difference between groups with respect to arterial cord pH [7.24 (7.21,7.26) vs. 7.23 (7.2,7.27), p=0.7]. Nor were there any associations between maternal characteristics and Apgar score at 5 minutes except Apgar score at 1 minute (p<0.001). No significant difference was identified in the rate of admission to the neonatal intensive care unit (NICU) [11 (52.4) vs. 10 (47.60], p=0.8] or NICU length of stay between GA vs. RA [4(3-14) vs. 4.5(3-11), p=0.9]. Conclusion Our data indicate that with prolonged IADT, favorable neonatal outcomes are seen with both GA and RA, in contrast with previous studies performed decades ago. This underscores the need for re-appraisal of historic outcomes reflecting new modalities, techniques, and advances in the medical field.

Proning in Pregnancies Complicated by Acute Respiratory Distress Syndrome. A Call to Action During the COVID-19 Pandemic.Authors: L Cojocaru, OM Turan, A Levine, L Sollecito, S Williams, E Elsamadicy, S Crimmins, S Turan.Liviu Cojocaru, MD: Division of Maternal-Fetal Medicine. Department of Obstetrics, Gynecology and Reproductive Science. University of Maryland School of Medicine, Baltimore, MD, USA.([email protected]) (ORCID No: 0000-0003-1558-702X).Ozhan M Turan, MD, Ph.D.: Division of Maternal-Fetal Medicine. Department of Obstetrics, Gynecology and Reproductive Science. University of Maryland School of Medicine, Baltimore, MD, USA.([email protected])Andrea Levine, MD: Division of Pulmonary and Critical Care Medicine. Department of Medicine. University of Maryland School of Medicine, Baltimore, MD, USA.([email protected])Linda Sollecito, BSN, RN, CCRN: Medical Intensive Care Unit. University of Maryland Medical Center, Baltimore, MD, USA.([email protected])Susan Williams, MS, RN, CCRN: Medical Intensive Care Unit. University of Maryland Medical Center, Baltimore, MD, USA.([email protected])Emad Elsamadicy, MD: Division of Maternal-Fetal Medicine. Department of Obstetrics, Gynecology and Reproductive Science. University of Maryland School of Medicine, Baltimore, MD, USA.([email protected])Sarah Crimmins, DO: Division of Maternal-Fetal Medicine. Department of Obstetrics, Gynecology and Reproductive Science. University of Maryland School of Medicine, Baltimore, MD, USA.([email protected])Shifa Turan, MD, RDMS: Division of Maternal-Fetal Medicine. Department of Obstetrics, Gynecology and Reproductive Science. University of Maryland School of Medicine, Baltimore, MD, USA.([email protected])Correspondence to: Liviu Cojocaru, MD: Division of Maternal-Fetal Medicine. Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA.([email protected])Disclosures: None.Acknowledgments: We are grateful to Bill Seiler, Erin Rummel, Kelly Kennedy, Alexandra Bessent, Chris Wells, McLellan Shelby, Jessica Peterson, and Amanda Sullivan for assistance in creating the proning video instructions.Short title: Proning in pregnancies complicated by ARDS. It’s time!