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. 2025 Mar 17:47:e-rbgo6.
doi: 10.61622/rbgo/2025rbgo6. eCollection 2025.

Effect of COVID-19 on Brazilian cesarean and prematurity rates: a cross-sectional study

Clarissa Suzart  1 , José Paulo de Siqueira Guida  1
Affiliations

Effect of COVID-19 on Brazilian cesarean and prematurity rates: a cross-sectional study

Clarissa Suzart et al. Rev Bras Ginecol Obstet. .

Abstract

Objective: To investigate the relationship between prematurity and cesarean section rate in Brazil during the beginning of COVID-19 pandemic.

Methods: Utilizing the Robson Classification, this study analyzed data from the Brazilian Ministry of Health's Live Births Panel, comparing CSR) and group 10 (preterm deliveries) between 2019 (pre-pandemic) and 2021 (pandemic) in each of Brazilian states and the overall country. The prematurity and CSR were compared using prevalence ratio and confidence interval, and p-value was obtained. The variation of prematurity and CSR were compared through the coefficient of determination (R2).

Results: A total of 5,522,910 deliveries were evaluated during the period. The CSR increased from 56.34% to 57.05% (p<0.01), and the frequency of preterm deliveries rose from 8.99% to 9.13% (p<0.01). The CSR increased in 23 States and decreased in 4 States, while the prematurity rate increased in 16 States and decreased in 10 States. A positive relationship between the increase of CSR and prematurity was observed during COVID-19, with an R2 value of 0.3121, suggesting a moderate association between these two variables.

Conclusion: Between 2019 (pre-COVID-19 pandemic) and 2021 (the first full year of the COVID-19 pandemic), there was an increase in prematurity and CSR in Brazil. These increases were observed in most Brazilian states and may be correlated. However, it is impossible to establish a cause-effect relationship given the design of this study.

Keywords: COVID-19; Cesarean delivery; Infant, newborn; Live birth; Maternal mortality; Pandemics; Prematurity.

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Conflict of interest statement

Conflicts to interest: none to declare.

Figures

Figure 1
Figure 1. Association between cesarean section rate and prematurity rates in Brazilian States
See this image and copyright information in PMC

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