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An Increase in Cesarean Section Rate During the First Wave of Covid-19 Pandemic in Iran Publisher Pubmed



Gharacheh M1 ; Kalan ME2, 3 ; Khalili N4 ; Ranjbar F1
Authors
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Authors Affiliations
  1. 1. Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Rashid Yasemi St., Valiasr Ave., P.O. Box 19395-4798, Tehran, Iran
  2. 2. School of Health Professions, Eastern Virginia Medical School, Norfolk, VA, United States
  3. 3. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
  4. 4. Department of Community and Family Medicine, School of Medicine, Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran

Source: BMC Public Health Published:2023


Abstract

Background: The COVID-19 pandemic and its impact on healthcare services is likely to affect birth outcomes including the delivery mode. However, recent evidence has been conflicting in this regard. The study aimed to assess changes to C-section rate during the COVID-19 pandemic in Iran. Methods: This is a retrospective analysis of electronic medical records of women delivered in the maternity department of hospitals in all provinces of Iran before the COVID-19 pandemic (February-August 30, 2019) and during the pandemic (February-August 30, 2020). Data were collected through the Iranian Maternal and Neonatal Network (IMAN), a country-wide electronic health record database management system for maternal and neonatal information. A total of 1,208,671 medical records were analyzed using the SPSS software version 22. The differences in C-section rates according to the studied variables were tested using the χ2 test. A logistic regression analysis was conducted to determine the factors associated with C-section. Results: A significant rise was observed in the rates of C-section during the pandemic compared to the pre-pandemic (52.9% vs 50.8%; p =.001). The rates for preeclampsia (3.0% vs 1.3%), gestational diabetes (6.1% vs 3.0%), preterm birth (11.6% vs 6.9%), IUGR (1.2% vs 0.4%), LBW (11.2% vs 7.8%), and low Apgar score at first minute (4.2% vs 3.2%) were higher in women who delivered by C-section compared to those with normal delivery (P =.001). Conclusions: The overall C-section rate during the first wave of COVID-19 pandemic was significantly higher than the pre-pandemic period. C-section was associated with adverse maternal and neonatal outcomes. Thus, preventing the overuse of C-section especially during pandemic becomes an urgent need for maternal and neonatal health in Iran. © 2023, The Author(s).
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1. Pregnancy-Related Complications During the Covid-19 Pandemic in Iran, Archives of Iranian Medicine (2024)
2. Prevalence of and Reasons for Women’S, Family Members’, and Health Professionals’ Preferences for Cesarean Section in Iran: A Mixed-Methods Systematic Review, Reproductive Health (2021)
3. Why Caesarean Is More Unequally Concentrated Among Better-Off People in Tehran? a Concentration Index Decomposition Approach, Journal of Epidemiology and Community Health (2019)
4. Evaluation of Pregnancy Outcomes in Mothers With Covid-19 Infection: A Systematic Review and Meta-Analysis, Journal of Obstetrics and Gynaecology (2023)
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