Abstract
Objective The objective of this study was to compare maternal outcomes of women with and without
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections who underwent
cesarean births.
Study Design This was a matched cohort study of pregnant women who had a cesarean birth between
March 15, 2020, and May 20, 2020. Cases included women who tested positive for SARS-CoV-2.
For every case, two patients who tested negative for SARS-CoV-2 were matched by maternal
age, gestational age, body mass index, primary or repeat cesarean birth, and whether
the procedure was scheduled or unscheduled. We compared rates of adverse postcesarean
complications (intraoperative bladder or bowel injury, estimated blood loss more than
or equal to 1,000 mL, hemoglobin drop more than 3 g/dL, hematocrit drop more than
10%, need for blood transfusion, need for hysterectomy, maternal intensive care unit
admission, postoperative fever, and development of surgical site infection), with
the primary outcome being a composite of those outcomes. We also assessed duration
of postoperative stay. Fisher's exact tests were performed to compare the primary
outcome between both groups.
Results Between March and May 2020, 202 women who subsequently underwent cesarean birth were
tested for SARS-CoV-2. Of those 202, 43 (21.3%) patients were positive. They were
matched to 86 patients who tested negative. There was no significant difference in
the rate of composite adverse surgical outcomes between the groups (SARS-CoV-2 infected
27.9%, SARS-CoV-2 uninfected 25.6%; p = 0.833). There was a higher rate of postoperative fevers (20.9 vs. 5.8%; p = 0.015), but that did not result in a longer length of stay (p = 0.302).
Conclusion Pregnant women with SARS-CoV-2 who underwent a cesarean birth did not have an increased
risk of adverse surgical outcomes, other than fever, compared with pregnant women
without SARS-CoV-2.
Key Points
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Women with SARS-CoV-2 had more postoperative fevers.
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Length of stay did not differ based on SARS-CoV-2 status.
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Composite postoperative outcome did not differ based on SARS-CoV-2 status.
Keywords
cesarean birth - COVID-19 - novel coronavirus - postoperative outcome - SARS-CoV-2
