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

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 classificati...

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Main Authors: Eva Morán Antolín, José Román Broullón Molanes, María Luisa de la Cruz Conty, María Begoña Encinas Pardilla, María del Pilar Guadix Martín, José Antonio Sainz Bueno, Laura Forcén Acebal, Pilar Pintado Recarte, Ana Álvarez Bartolomé, Juan Pedro Martínez Cendán, Óscar Martínez-Pérez, on behalf of the Spanish Obstetric Emergency Group
Format: Article
Language:English
Published: MDPI AG 2021-11-01
Series:Viruses
Subjects:
Online Access:https://www.mdpi.com/1999-4915/13/11/2330
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author Eva Morán Antolín
José Román Broullón Molanes
María Luisa de la Cruz Conty
María Begoña Encinas Pardilla
María del Pilar Guadix Martín
José Antonio Sainz Bueno
Laura Forcén Acebal
Pilar Pintado Recarte
Ana Álvarez Bartolomé
Juan Pedro Martínez Cendán
Óscar Martínez-Pérez
on behalf of the Spanish Obstetric Emergency Group
author_facet Eva Morán Antolín
José Román Broullón Molanes
María Luisa de la Cruz Conty
María Begoña Encinas Pardilla
María del Pilar Guadix Martín
José Antonio Sainz Bueno
Laura Forcén Acebal
Pilar Pintado Recarte
Ana Álvarez Bartolomé
Juan Pedro Martínez Cendán
Óscar Martínez-Pérez
on behalf of the Spanish Obstetric Emergency Group
author_sort Eva Morán Antolín
collection DOAJ
description 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 (<i>p</i> < 0.05) compared with women who delivered vaginally. Moreover, C-section risk was associated with the presence of pneumonia (<i>p</i> < 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 (<i>p</i> = 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 (<i>p</i> < 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.
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spelling doaj.art-6de6369e3e6c4e20b90c8358118fd2b72023-11-23T01:58:57ZengMDPI AGViruses1999-49152021-11-011311233010.3390/v13112330SARS-CoV-2 Infection and C-Section: A Prospective Observational StudyEva Morán Antolín0José Román Broullón Molanes1María Luisa de la Cruz Conty2María Begoña Encinas Pardilla3María del Pilar Guadix Martín4José Antonio Sainz Bueno5Laura Forcén Acebal6Pilar Pintado Recarte7Ana Álvarez Bartolomé8Juan Pedro Martínez Cendán9Óscar Martínez-Pérez10on behalf of the Spanish Obstetric Emergency GroupDepartment of Gynecology and Obstetrics, Son Espases University Hospital, 07120 Palma de Mallorca, SpainDepartment of Gynecology and Obstetrics, Puerta del Mar University Hospital, 1109 Cádiz, SpainFundación de Investigación Biomédica, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, SpainDepartment of Gynecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, SpainDepartment of Gynecology and Obstetrics, Virgen de la Macarena University Hospital, 41009 Sevilla, SpainDepartment of Gynecology and Obstetrics, G. Chacon (Viamed Santa Angela de la Cruz Hospital), 41014 Sevilla, SpainDepartment of Gynecology and Obstetrics, 12 de Octubre University Hospital, 28041 Madrid, SpainDepartment of Gynecology and Obstetrics, Gregorio Marañon University Hospital, 28007 Madrid, SpainDepartment of Anesthesia and Resuscitation, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, SpainDepartment of Gynecology and Obstetrics, Santa Lucia University Hospital, 30202 Cartagena, SpainDepartment of Gynecology and Obstetrics, Puerta de Hierro University Hospital of Majadahonda, 28222 Madrid, SpainPregnant 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 (<i>p</i> < 0.05) compared with women who delivered vaginally. Moreover, C-section risk was associated with the presence of pneumonia (<i>p</i> < 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 (<i>p</i> = 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 (<i>p</i> < 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.https://www.mdpi.com/1999-4915/13/11/2330SARS-CoV-2COVID-19pregnancydeliveryC-sectionRobson’s ten group
spellingShingle Eva Morán Antolín
José Román Broullón Molanes
María Luisa de la Cruz Conty
María Begoña Encinas Pardilla
María del Pilar Guadix Martín
José Antonio Sainz Bueno
Laura Forcén Acebal
Pilar Pintado Recarte
Ana Álvarez Bartolomé
Juan Pedro Martínez Cendán
Óscar Martínez-Pérez
on behalf of the Spanish Obstetric Emergency Group
SARS-CoV-2 Infection and C-Section: A Prospective Observational Study
Viruses
SARS-CoV-2
COVID-19
pregnancy
delivery
C-section
Robson’s ten group
title SARS-CoV-2 Infection and C-Section: A Prospective Observational Study
title_full SARS-CoV-2 Infection and C-Section: A Prospective Observational Study
title_fullStr SARS-CoV-2 Infection and C-Section: A Prospective Observational Study
title_full_unstemmed SARS-CoV-2 Infection and C-Section: A Prospective Observational Study
title_short SARS-CoV-2 Infection and C-Section: A Prospective Observational Study
title_sort sars cov 2 infection and c section a prospective observational study
topic SARS-CoV-2
COVID-19
pregnancy
delivery
C-section
Robson’s ten group
url https://www.mdpi.com/1999-4915/13/11/2330
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