The associated factors of cesarean section during COVID-19 pandemic: a cross-sectional study in nine cities of China
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(2020) 25:60
Environmental Health and Preventive Medicine
RESEARCH ARTICLE
Open Access
The associated factors of cesarean section during COVID-19 pandemic: a crosssectional study in nine cities of China Jian Zhang1,2, Yumei Zhang2, Yidi Ma2, Yalei Ke2, Shanshan Huo2, Liping He3, Wenjuan Luo4, Jing Li5 and Ai Zhao1*
Abstract Background: Improving and maintaining the health of mothers and newborns is indisputably a global priority, especially during a pandemic. This study intends to examine the factors associated with cesarean section (CS) during lockdown time. Methods: A total of 678 women who just gave birth within 7 days were enrolled from maternal and children hospitals in nine cities of China from April to May 2020. The delivery modes and potential influencing factors were investigated. The subgroup analysis and sensitivity analysis were used to examine the association of CS and risk factors among populations with different characteristics and to control for possible confounding, respectively. Results: The overall rate of cesarean delivery was 37.3%. In multi-variant model, maternal age > 30 years (OR, 95% CI = 1.71, 1.21–2.41), higher pre-gestational BMI (OR, 95% CI = 1.16, 1.10–1.23), living in regions with confirmed COVID-19 cases > 500 (OR, 95% CI = 2.45, 1.74–3.45), and excess gestational weight gain (OR, 95% CI = 1.73, 1.17– 2.55) were associated with cesarean delivery. These trends of associations were not changes in sensitivity analysis and subgroup analysis. Cesarean delivery occurred more in women who got more nutrition instruction during the pandemic period in the univariant model; however, this association showed insignificance in the multiple-variant analysis. Conclusion: A high cesarean delivery rate was found in uninfected women who experienced lockdown in their third trimester. During the COVID-19 pandemic, more medical support should be provided in severely affected regions to ensure and promote health in pregnancy. Keywords: COVID-19, Pregnancy, Cesarean section, Gestational weight gain
Introduction The 2019 novel coronavirus (COVID-19), a severe acute respiratory syndrome caused by a coronavirus, was declared as a pandemic by the World Health Organization (WHO) on March 11, 2020 [1], due to its highly contagious nature, subsequently spreading around the world and infecting more than 13 million confirmed cases by July 15 [2]. This is still true today as the world continues * Correspondence: [email protected] 1 Vanke School of Public Health, Tsinghua University, Beijing 100091, China Full list of author information is available at the end of the article
to grapple with the COVID-19 pandemic. China and many countries have adopted several measures to control disease transmission, including travel restrictions, early detection, isolation of suspected and confirmed cases, and widespread quarantines [3, 4]. Improving the survival and well-being of mothers and newborns is indisputably a global priority, especially during pandemic [5]. Since COVID-19 broke out, there has been plenty of re
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