Investigating Decreased Rates of Nulliparous Cesarean Deliveries during the COVID-19 Pandemic

8Citations
Citations of this article
27Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Objective Preventing the first cesarean delivery (CD) is important as CD rates continue to rise. During the novel coronavirus disease 2019 (COVID-19) pandemic, quality improvement metrics at our hospital identified lower rates of CD. We sought to investigate this change and identify factors that may have contributed to the decrease. Study Design We compared nulliparous singleton deliveries at a large academic hospital during the COVID-19 pandemic (April through July 2020 during a statewide stay-at-home order) to those in the same months 1 year prior to the pandemic (April through July 2019). The primary outcome, mode of delivery, was obtained from the electronic medical record system, along with indication for CD. Results The cohort included 1,913 deliveries: 892 in 2019 and 1,021 in 2020. Patient characteristics (age, body mass index, race, ethnicity, and insurance type) did not differ between the groups. Median gestational age at delivery was the same in both groups. The CD rate decreased significantly during the COVID-19 pandemic compared with prior (28.9 vs. 33.6%; p = 0.03). There was a significant increase in the rate of labor induction (45.7 vs. 40.6%; p = 0.02), but no difference in the proportion of inductions that were elective (19.5 vs. 20.7%; p = 0.66). The rate of CD in labor was unchanged (15.9 vs. 16.3%; p = 0.82); however, more women attempted a trial of labor (87.0 vs. 82.6%; p = 0.01). Thus, the proportion of CD without a trial of labor decreased (25.1 vs. 33.0%; p = 0.04). Conclusion There was a statistically significant decrease in CD during the COVID-19 pandemic at our hospital, driven by a decrease in CD without a trial of labor. The increased rate of attempted trial of labor suggests the presence of patient-level factors that warrant further investigation as potential targets for decreasing CD rates. Additionally, in a diverse and medically complex population, increased rates of labor induction were not associated with increased rates of CD.

References Powered by Scopus

Labor induction versus expectant management in low-risk nulliparous women

851Citations
N/AReaders
Get full text

Safe prevention of the primary cesarean delivery This document was developed jointly by the with the assistance of

665Citations
N/AReaders
Get full text

Morbidity associated with cesarean delivery in the United States: Is placenta accreta an increasingly important contributor?

107Citations
N/AReaders
Get full text

Cited by Powered by Scopus

Comparison of Pregnancy and Birth Outcomes Before vs During the COVID-19 Pandemic

50Citations
N/AReaders
Get full text

Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital

3Citations
N/AReaders
Get full text

Pre and Post-Lockdown Cesarean Deliveries and Perinatal Quality Indicators During the COVID-19 Pandemic

3Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Sinnott, C. M., Freret, T. S., Clapp, M. A., Reiff, E., & Little, S. E. (2021, October 1). Investigating Decreased Rates of Nulliparous Cesarean Deliveries during the COVID-19 Pandemic. American Journal of Perinatology. Thieme Medical Publishers, Inc. https://doi.org/10.1055/s-0041-1732449

Readers over time

‘21‘22‘23‘24036912

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 6

67%

Professor / Associate Prof. 3

33%

Readers' Discipline

Tooltip

Medicine and Dentistry 8

73%

Nursing and Health Professions 2

18%

Business, Management and Accounting 1

9%

Save time finding and organizing research with Mendeley

Sign up for free
0