Background and Aims Drugs administered on the mother can cross the placental barrier. The objective of the study is to analyze the effect of anesthetics used in caesarean section in the bilirubin level in neonates.

Methods This is a cross sectional study realized between August 2011 and March 2012, in rooming-in at Universidade Luterana do Brasil Hospital. All the babies born at term, without hemolytic disease, no fetal anomalies, apgar greater than 7 in the fifth minute and breastfeeding only. The transcutaneous bilirubin levels (TBLs) were obtained by the apparatus Dräger Jaundice Meter JM-103®. The TBLs variable was stratified according to the Bhutani nomogram. Were measured TBLs between 24 and 59 hours of life. This study was approved by the Ethics in Research.

Results From a total of 670 babies, 220(32.8%) were delivered by caesarean section by epidural anaesthesia using bupivacaine (group A). In this group, 62.2% received morphine, 12.2% fentanyl and 36.8% sufentanil. The use of different opioids presented no significant association in TBLs, when compared with vaginally delivery. The TBLs in neonates of group A were lower than vaginally delivered (p=0.014). The use of bupivacaine decreased the risk of developing hyperbilirubinemia (p=0.010). The use of ephedrine, a vasoconstrictor, by 148(22%), only in group A, showed a lower risk of developing jaundice (p=0.010). The Buthani nomogram classified as low risk 530(79.1%) neonates.

Conclusions Babies born by cesarean have a higher probability to be classified as lower risk of developing hyperbilirubinemia (p=0.015). Further studies are needed for definite results.