Do maternal albumin levels affect post-operative complications after cesarean delivery?

Abstract

Background This study explored the correlation between maternal serum albumin levels prior to elective cesarean delivery (CD) and postoperative complications. Methods This retrospective cohort study included women admitted for elective CD at term to our tertiary referral center, during the years 2016–2018. Blood samples were collected during the preoperative admission. Information collected included maternal demographics, pregnancy and postoperative complications. Data between patients with preoperative serum albumin levels < 3.3 g/dL or ≥ 3.3 g/dL were compared. Results Among 796 women admitted for an elective CD, 537 met the inclusion criteria. There were 250 (46.6%) women in the low albumin level group (< 3.3 g/dL) and 287 (53.4%) with serum albumin level ≥ 3.3 g/dL. Patients with serum albumin ≥ 3.3 g/dL had increased rates of surgical site infection (SSI) (5.6% vs. 1.6% respectively; p = 0.02), need for antibiotics during the post-partum period (10.8% vs 3.2%, respectively; p = 0.001), surgical intervention (2.1% vs. 0%, respectively; p = 0.03) and higher rate of rehospitalization (5.2% vs. 0.4%, respectively; p = 0.001). Multivariant analysis showed that albumin level ≥ 3.3 g/dL was independently associated with composite postoperative adverse maternal outcome. Conclusions High serum albumin levels among women undergoing CD, might be associated with abnormal postoperative outcomes. Larger prospective studies, with a heterogenous population are needed to validate these observations.

Pregnancy and postpartum dynamics revealed by an atlas of millions of lab tests

“…The atlas shows that albumin and total protein concentration tests drop gradually during the first trimester, and stay low until delivery and then recover over a few weeks postpartum. This follows the temporal profile of blood volume growth, and may be attributed to uncompensated hemodilution 58 . In contrast, globulin stays relatively constant.…”

Comment on: “Do maternal albumin levels affect post-operative complications after cesarean delivery?”

“…Maternal SSI after cesarean delivery is a clinical problem that contributes to significant morbidity and mortality rates. We read with great interest the study by Yagur et al, who published a retrospective cohort study, the first to analyze the relationship between maternal serum albumin levels before elective cesarean delivery (CD) and postoperative complications [ 3 ]. The results suggested that high serum albumin levels among women undergoing CD might be associated with abnormal postoperative outcomes.…”

Correction: Do maternal albumin levels affect post-operative complications after cesarean delivery?

“…Following the publication of the original article [ 1 ], it was noted that due to a typesetting error the heading of the second column of Tables 1 and 2 should read “Serum albumin level < 3.3 ( n = 250).…”