Retrospective evaluation of cesarean cases with and without COVİD vaccination

Aim: Covid-19 vaccination is the safest and most effective way for pregnant women to protect themselves and their babies against severe covid-19 disease. Ava-ilable data do not support an increased risk of adverse outcomes after covid-19 vac-cination in pregnancy, therefore vaccination is recommended as the benefits of vac-cination in pregnancy outweigh the potential risks. In our study, we aimed to evalu-ate the effect of vaccination status of pregnant women who underwent cesarean sec-tion in our hospital for 1 year primarily on maternal and neonatal outcomes and secondarily on postoperative neutrophil/lymphocyte (N/L) ratio. Materials and Methods: After ethics committee approval, 430 patients who underwent cesarean section between 01.01.2022 and 01.01.2023 were included in the study. Patients' age, comorbidities, gestational weeks, education level, anesthe-sia method, operation time, whether they had Covid 19, whether they had Covid vaccine, perioperative blood and/or blood product use, 1st and 5th minute APGAR scores, postoperative discharge status, hospitalization time, postoperative complica-tions and mortality were analyzed. Results: Of the 430 patients included in the study, 329 patients had received at least 1 dose of COVID-19 vaccine in the pre-pregnancy period and 101 patients had not received COVID-19 vaccine. The median age of vaccinated and unvaccina-ted mothers was 29 years, and the age of the unvaccinated group was significantly lower than the vaccinated group (p=0.003). The median body mass index (BMI) of the patients was 29 and there was no significant difference between the two groups (p=0.722). The median gestational age was also similar in both groups (p=0.480). While 34.2% of the patients were high school graduates, 25.8% were middle school graduates, 21.2% were undergraduates, 14.7% were primary school graduates and 4.2% were illiterate; there was a significant difference between the two groups in terms of educational level (p=0.001). Vaccination rate increased significantly with increasing education level (p=0,003). Comorbidities were present in 26.7% of the patients, and the rate of comorbidities was higher in the vaccinated group than in the non-vaccinated group (p=0.039). The most common vaccine was Biontec with a rate of 74.2%, the least common vaccine was Turkovac with a rate of 0.3% and the most common period was the pre-pregnancy period. 77.9% of the patients had not had Covid and there was no significant difference between the two groups (p=0.719). While 67.4% of the patients were operated for elective operation, 32.6% were operated urgently. There were no complications in 97.4% of the patients. Pos-toperatively, 99.3% of the patients went to the ward, while 0.7% went to the inten-sive care unit. All patients participating in the study were discharged with cure and no mortality was observed (1 month). APGAR 1st minute scores of patients who were vaccinated were statistically significantly higher than those who were not vac-cinated (p=0.020). APGAR 5th minute scores were similar in both groups (p=0.248). Hb, Hct, PLt, MPV and N/L ratios were similar in both groups. Conclusion: The data obtained from our study show that COVID-19 vacci-nation during pregnancy does not increase the risk of adverse maternal and neonatal outcomes. However, studies involving larger and diverse populations with compre-hensive data on vaccination, comorbidities and birth outcomes are needed to increa-se the general acceptability of this information. Key words: Vaccination, Covid-19 vaccine, Covid-19, Pregnancy, Anesthe-sia