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Impact of the Coronavirus Disease 2019 Pandemic and Seasonal Factors on Surgical Site Infection Rates Following
Xiaona Xu1,2,3, Jue Ma1,2,3, Juanxiu Lv2,3
1Department of Obstetrics, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Surgical site infections (SSIs) after cesarean delivery increased post-pandemic, with higher rates observed in summer and winter months. This study highlights seasonal impacts on SSIs following cesarean births.
Area of Science:
- Obstetrics and Gynecology
- Infectious Disease Epidemiology
- Public Health
Background:
- Surgical site infections (SSIs) are a significant concern following cesarean deliveries.
- Limited research exists on the influence of seasonal variations and the COVID-19 pandemic on cesarean delivery SSIs.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic and seasonal factors on the incidence of SSIs after cesarean delivery.
- To analyze trends in SSI rates across pre-pandemic, pandemic, and post-pandemic normalization periods.
Main Methods:
- Retrospective cohort analysis of cesarean delivery patients from January 2017 to September 2024.
- Inclusion criteria: minimum 30-day post-operative follow-up and adherence to CDC SSI diagnostic criteria.
- Statistical analysis included t-tests, ANOVA, chi-squared tests, and time series analysis using Seasonal Autoregressive Integrated Moving Average (SARIMA) models.
Main Results:
- SSI rates showed an upward trend: 0.4884% (pre-pandemic), 0.5007% (pandemic), and 0.7747% (post-pandemic normalization).
- The post-pandemic normalization period exhibited the highest SSI rate.
- Seasonal analysis indicated increased SSI rates during summer and year-end, with lower rates in spring.
Conclusions:
- The incidence of SSIs following cesarean deliveries significantly increased after the transition to normalized COVID-19 management.
- A distinct seasonal pattern was observed, with higher SSI rates during humid summer months and colder winter months.
- Findings underscore the need for strategies addressing seasonal and pandemic-related influences on post-cesarean SSIs.
Background:
Surgical site infections (SSIs) are common after cesarean deliveries, with few studies exploring their correlation with seasonal changes and the coronavirus disease 2019 (COVID-19) pandemic. This study aims to explore the impact of the COVID-19 pandemic and seasonal factors on the rate of SSIs following cesarean delivery.
Patients And Methods:
A retrospective cohort analysis was conducted to investigate trends in SSI rates following cesarean sections at the International Peace Maternity and Child Health Hospital from January 2017 to September 2024. The study included women who underwent cesarean sections with at least 30 days of post-operative follow-up and met the US Centers for Disease Control and Prevention's SSI diagnostic criteria. Cases were categorized into pre-pandemic (n = 109), pandemic (n = 87), and post-pandemic normalization groups (n = 88). Statistical analyses included descriptive statistics, t-tests, analysis of variance, and chi-squared tests using SPSS 25.0, whereas time series analysis used a Seasonal Autoregressive Integrated Moving Average model in Python 3.12, with significance set at p < 0.05.
Results:
(1) The SSI rate increased from 0.4884% in the pre-pandemic period to 0.5007% during the pandemic, reaching 0.7747% in the post-pandemic period, indicating a rising trend across the three time frames, with the post-pandemic period showing the highest rate. (2) Monthly analysis revealed seasonal fluctuations, with greater SSI rates in summer and at year's end, whereas spring exhibited relatively lower rates.
Conclusions:
After the transition to normalized COVID-19 management, the incidence of SSIs following cesarean deliveries substantially increased, displaying a clear seasonal pattern with greater rates in humid summer months and colder months at the year's end.
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