Baltali Sevim, Baltali Mehmet, Ercan Ayşegül, Akdağ Umut Deniz, Toptaş Mehmet
Department of Anesthesiology and Reanimation, Istanbul Training and Research Hospital, University of Health Sciences, Kasap İlyas Mah. Org. Abdurrahman Nafiz Gürman Cd. 34098 Fatih, Istanbul, Turkey.
Department of Cardiology, Faculty of Medicine, Uskudar University, Saray Mah. Ahmet Tevfik İleri Cad. No:18 - 34768, Ümraniye, Istanbul, Turkey.
BMC Pregnancy Childbirth. 2025 Jul 2;25(1):694. doi: 10.1186/s12884-025-07805-8.
The aim of the study was to examine the impact of the COVID-19 pandemic on changes in the choice of anaesthetic techniques for singleton caesarean sections among Turkish citizens and migrants before, during the first year of the COVID-19 pandemic, and after vaccination.
This single-center, retrospective observational study was conducted at a tertiary care hospital in Istanbul, Turkey. It included data from 9,744 consecutive women-7,083 (72.7%) Turkish citizens and 2,661 (27.3%) migrants-who underwent singleton caesarean sections between March 2018 and March 2023. The primary outcome was the change in monthly utilization rates of neuraxial anaesthesia (NA) during the COVID-19 pandemic. Secondary objectives included caesarean section urgency and neonatal outcomes.
During the study period, there was an increasing trend in the number of caesarean sections performed using NA among Turkish citizens and migrants (relative ratio [RR] 1.003, P < 0.001 and RR 1.005, P < 0.01, respectively). Both groups showed a significant immediate increase in the usage rate of NA at the onset of the COVID-19 pandemic (RR 1.095, P < 0.001 and 1.134, P < 0.001, respectively). The introduction of vaccination had no effect on the use of NA (RR 0.970, P = 1.004, and RR 1.000, P = 0.99, respectively). The significant between-group difference in the pre-pandemic usage rate of NA diminished following the onset of the COVID-19 pandemic, with no significant between-group difference observed after vaccination (93.3% vs. 90.9%., P = 0.006, 98.4% vs. 97.1%, P = 0.0; 95.4% vs. 95.2%, P = 0.801, respectively). Category-1 caesarean section events increased throughout the study period (471(10.7%) before COVID-19, 321(17.0%) during the first year, and 700 (20.2%) after vaccination; P < 0.001). There were no significant differences in the incidence of composite adverse neonatal outcomes (stillbirths, Apgar 5-min score < 7) among the three time periods (89(2.0%), 41(2.2%), and 49(1.4%); P = 0.065).
During the COVID-19 pandemic, our study revealed a continuation of the upward trend in the use of NA for caesarean sections.
本研究旨在探讨2019冠状病毒病（COVID-19）大流行对土耳其公民和移民在大流行前、大流行第一年期间以及接种疫苗后单胎剖宫产麻醉技术选择变化的影响。
本单中心回顾性观察研究在土耳其伊斯坦布尔的一家三级护理医院进行。研究纳入了2018年3月至2023年3月期间连续进行单胎剖宫产的9744名妇女的数据，其中7083名（72.7%）为土耳其公民，2661名（27.3%）为移民。主要结局是COVID-19大流行期间神经轴索麻醉（NA）每月使用率的变化。次要目标包括剖宫产的紧迫性和新生儿结局。
在研究期间，土耳其公民和移民中使用NA进行剖宫产的数量呈上升趋势（相对比率[RR]分别为1.003，P<0.001和RR 1.005，P<0.01）。两组在COVID-19大流行开始时NA使用率均立即显著增加（RR分别为1.095，P<0.001和1.134，P<0.001）。疫苗接种的引入对NA的使用没有影响（RR分别为0.970，P=1.004和RR 1.000，P=0.99）。COVID-19大流行开始后，大流行前NA使用率的组间显著差异减小，接种疫苗后未观察到组间显著差异（分别为93.3%对90.9%，P=0.006；98.4%对97.1%，P=0.0；95.4%对95.2%，P=0.801）。在整个研究期间，1类剖宫产事件增加（COVID-19前471例（10.7%），第一年期间321例（17.0%），接种疫苗后700例（20.2%）；P<0.001）。三个时间段内复合不良新生儿结局（死产、5分钟Apgar评分<7）的发生率无显著差异（分别为89例（2.0%）、41例（2.2%）和49例（1.4%）；P=0.065）。
在COVID-19大流行期间，我们的研究显示剖宫产使用NA呈上升趋势仍在持续。
