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Am J Perinatol 2023; 40(12): 1367-1372
DOI: 10.1055/s-0041-1739430
Original Article

Cesarean Birth Morbidity among Women with SARS-CoV-2

Rodney McLaren Jr.
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York
,
Viktoriya London
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York
,
Sujatha Narayanamoorthy
2   Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York
,
Fouad Atallah
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York
,
Michael Silver
3   Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York
,
Howard Minkoff 
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York
4   Department of Obstetrics and Gynecology, SUNY Downstate Medical Center, Brooklyn, New York
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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

  • Women with SARS-CoV-2 had more postoperative fevers.

  • Length of stay did not differ based on SARS-CoV-2 status.

  • Composite postoperative outcome did not differ based on SARS-CoV-2 status.

Keywords

cesarean birth - COVID-19 - novel coronavirus - postoperative outcome - SARS-CoV-2

Note

This study was presented as a virtual poster presentation at the Society for Maternal-Fetal Medicine's 41st Annual Pregnancy Meeting on January 29, 2021.




Publikationsverlauf

Eingereicht: 01. November 2020

Angenommen: 04. Oktober 2021

Artikel online veröffentlicht:
14. November 2021

© 2021. Thieme. All rights reserved.

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