The impact of coronavirus disease 2019 (COVID-19) on the perioperative outcomes of emergency cesarean section in maternal and neonatal prognosis: A propensity score-matched analysis

Abstract Objective To evaluate the impact of COVID-19 infection on maternal and neonatal prognosis. Study Design and Setting: This retrospective, propensity score-matched analysis was conducted at Beijing Tiantan Hospital, China, from October 2022 to December 2022. Participants: We retrospectively collected clinical data from 711 parturient women and their neonates. The inclusion criteria were: 1) parturient women who underwent emergency caesarean section within less than 2 hours; 2) parturient women who underwent nucleic acid testing for COVID-19; and 3) at least one COVID-19 related clinical symptom, such as fever, cough, nausea, or other symptoms. The exclusion criteria were parturient women who had natural childbirth or lacked COVID-19 related clinical symptoms. Methods Propensity score matching (PSM) was performed based on whether the parturient women were infected with COVID-19 (defined as nucleic acid test positive combined with at least one clinical symptom related to COVID-19 infection, versus test negative). The covariates included age, height, weight, Body Mass Index (BMI), weight gain during pregnancy, anesthesia method, gestational week, term pregnancy, preoperative routine blood test, and coagulation function. Results The research cohort ultimately included 58 parturient women and their newborns through PSM and inverse probability of treatment (n = 29 positive, n = 29 negative). There was a lower incidence of fetal distress in the non-infected group (17.24% vs 44.83%, OR = 3.9, 95% CI 1.163–13.078, P = 0.023). The anesthesia satisfaction score and postoperative recovery quality (QoR-15) score were higher in the non-infected group (10 vs 10, P = 0.005 and 144 vs 148, P = 0.029, respectively). Conclusion COVID-19 infection combined with related clinical symptoms may increase the likelihood of fetal distress and reduce maternal satisfaction with anesthesia and postoperative recovery quality scores.