Background and Aims Recent reviews have reported a higher incidence for pregnant patients to be intensive care unit admission and mechanical ventilation that experiencing severe COVID 19. This study aims to evaluate the impact of COVID-19 infection on obstetric anesthesia.

Methods The study population consisted of patients who underwent cesarean section procedures covered by the Korean National Health Insurance System (KNHI) between January 1, 2020, and December 31, 2021. The KNHI provides coverage to approximately 97% of Koreans, while the remaining 3% who cannot afford national insurance are covered by the Medical Aid Program. The database used in this study was provided by the National Health Insurance Sharing Service, which includes virtually all operations performed in Korea during the study period. The study protocol was reviewed by the Institutional Review Board of Seoul Paik Hospital (IRB No PAIK 2023-05-001) and was exempted due to the use of de-identified administrative data. The major inclusion criterion was admission with operation codes specific to cesarean section procedures (R4514, R4516, R4517, R4518, R4519, R4520, R4507, R4508, R4509, R4510, R5001, R5002). The study assessed mortality and pulmonary complications.

Results 75,703 patients were had cesarean section, among them 383 patients (0.51%) with diagnosis code (U071) within 30 days before surgery or within 30 days after surgery. During the period, mortality were 0.05%. Overall and 30 days’ pulmonary complications were 1.06% and 0.15%. Mortality were increased in general anesthesia than regional anesthesia.

Conclusions The findings support the consideration of regional anesthesia as a preferred choice in cesarean section during the COVID-19 pandemic.