Impact of Mode of Birth and Type of Anesthesia on Clinical Outcomes of Pregnant Women with COVID-19 in a Referral Pandemic Hospital: An Analytical Study

Abstract

Objective: During the pandemic, pregnant women were more likely to develop severe illness, necessitating critical care, and require mechanical ventilation. Birth of the pregnant women can be necessary for the rapid decline in mother’s clinical situation or for obstetric indication. This study aimed to investigate the clinical outcomes of pregnant women who gave birth during coronavirus disease-2019 (COVID-19) isolation period with regard to mode of birth and type of anesthesia in cesarean delivery. Material and Methods: The clinical outcomes of pregnant women who were admitted to the hospital, confirmed to be infected with severe acute respiratory syndrome-coronavirus-2, and gave birth during the hospitalization for COVID-19 treatment or isolation period between March, 2020 and November, 2021were analyzed according to mode of birth and type of anesthesia, retrospectively. Results: Among all pregnant women, 106 (%35.45) gave birth vaginally while 193 (64.55%) underwent cesarean section. Out of all cesarean births, 55 (28.5%) and out of all vaginal births, 2 (1.9%) had indication of birth as deterioration of maternal clinical status. Intensive care unit admission rate was 23.3%, maternal mortality rate was 11.9%, and preterm birth rate (<34 week) was 18.1% (odds ratio: 2.311, 95% confidence interval: 1.155-4.625) for cesarean births. There were 131 (67.88%) cesarean births with spinal anesthesia and 62 (32.12%) cesarean births with general anesthesia. Conclusion: The critical factor influencing the method and timing of birth as well as the negative outcomes for pregnant COVID-19 patients was the clinical severity and change in clinical status. © 2023 Elsevier B.V., All rights reserved.