755 Cesarean birth morbidity among women with SARS-CoV-2

McLaren, Rodney; London, Viktoriya; Narayanamoorthy, Sujatha; Atallah, Fouad; Silver, Michael; Minkoff, Howard

Objective: Many infected women undergo cesarean delivery, but whether they face an increased risk of perioperative morbidity is unknown. The objective of this study was to compare maternal outcomes of women with and without 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 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 post cesarean complications (intraoperative bladder or bowel injury, estimated blood loss greater than or equal to 1000 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 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 groups (SARS-CoV-2 infected 27.9%, SARS-CoV-2 uninfected 25.6%;p=.833) (Table 1). There was a higher rate of postoperative fevers (20.9% vs. 5.8%;p=.015), but that did not result in a longer length of stay (p=.302) (Table 2). 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 to pregnant women without SARS-CoV-2. [Formula presented] [Formula presented]