Impact of the Coronavirus Disease 2019 Pandemic and Seasonal Factors on Surgical Site Infection Rates Following Cesarean Section: A Retrospective Study Based on Time Series Analysis

Abstract

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.