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Observational Study
. 2021 Nov 22;13(11):2330.
doi: 10.3390/v13112330.

SARS-CoV-2 Infection and C-Section: A Prospective Observational Study

Eva Morán Antolín  1 , José Román Broullón Molanes  2 , María Luisa de la Cruz Conty  3 , María Begoña Encinas Pardilla  4 , María Del Pilar Guadix Martín  5 , José Antonio Sainz Bueno  6 , Laura Forcén Acebal  7 , Pilar Pintado Recarte  8 , Ana Álvarez Bartolomé  9 , Juan Pedro Martínez Cendán  10 , Óscar Martínez-Pérez  4   11   12 , On Behalf Of The Spanish Obstetric Emergency Group
Affiliations
Observational Study

SARS-CoV-2 Infection and C-Section: A Prospective Observational Study

Eva Morán Antolín et al. Viruses. .

Abstract

Pregnant women are particularly vulnerable to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. In addition to unfavorable perinatal outcomes, there has been an increase in obstetric interventions. With this study, we aimed to clarify the reasons, using Robson's classification model, and risk factors for cesarean section (C-section) in SARS-CoV-2-infected mothers and their perinatal results. This was a prospective observational study that was carried out in 79 hospitals (Spanish Obstetric Emergency Group) with a cohort of 1704 SARS-CoV-2 PCR-positive pregnant women that were registered consecutively between 26 February and 5 November 2020. The data from 1248 pregnant women who delivered vaginally (vaginal + operative vaginal) was compared with those from 456 (26.8%) who underwent a C-section. C-section patients were older with higher rates of comorbidities, in vitro fertilization and multiple pregnancies (p < 0.05) compared with women who delivered vaginally. Moreover, C-section risk was associated with the presence of pneumonia (p < 0.001) and 41.1% of C-sections in patients with pneumonia were preterm (Robson's 10th category). However, delivery care was similar between asymptomatic and mild-moderate symptomatic patients (p = 0.228) and their predisposing factors to C-section were the presence of uterine scarring (due to a previous C-section) and the induction of labor or programmed C-section for unspecified obstetric reasons. On the other hand, higher rates of hemorrhagic events, hypertensive disorders and thrombotic events were observed in the C-section group (p < 0.001 for all three outcomes), as well as for ICU admission. These findings suggest that this type of delivery was associated with the mother's clinical conditions that required a rapid and early termination of pregnancy.

Keywords: C-section; COVID-19; Robson’s ten group; SARS-CoV-2; delivery; perinatal outcomes; pneumonia; pregnancy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study data.
See this image and copyright information in PMC

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