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Infectious Diseases in Obstetrics and Gynecology
Volume 5 (1997), Issue 1, Pages 29-35
Cesarean Delivery in Women With Genital Herpes in Washington State, 1989–1991
1Department of Medicine, University of Washington, Seattle, WA, USA
2Department of Epidemiology, University of Washington, Seattle, WA, USA
3Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
4Department of Microbiology, University of Washington, Seattle, WA, USA
5Broadway STD Clinic, 1001 Broadway, Suite 320, Mailstop 359928, Seattle 98122, WA, USA
Received 27 December 1996; Accepted 16 May 1997
Copyright © 1997 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: The purpose of this study was to determine whether the proportion of cesarean deliveries in pregnant women with a history of genital herpes and no active lesions at birth is higher than that in women with no history of genital herpes, and to determine whether this risk was modified by birth facilities' underlying prevalence of cesarean delivery.
Methods: This was a retrospective survey. Women who gave birth in Washington state from 1989 to 1991 were identified from the state birth records and were classified as having clinical genital herpes during pregnancy (N = 1,094) or history of genital herpes only (N = 4,163) at delivery. Women without genital herpes (N = 5,257) were randomly selected from remaining births.
Results: The main outcome measure was primary cesarean delivery, excluding those performed for indications other than genital herpes. Prevalence of primary cesarean delivery was 59.5% in women with clinical herpes during pregnancy and 12.5% in women with history of herpes, both significantly different from prevalence of 11.2% in unexposed women. Age-adjusted risk for cesarean delivery among women with a history of herpes was 1.13 [95% confidence interval (CI): 0.93, 1.37]. When baseline cesarean delivery prevalence was above 20%, this risk was 1.2 (95% CI: 1.0, 1.4; P = 0.058), compared to 1.1 (95% CI: 0.9, 1.3; P = 0.186) where cesarean delivery prevalence was below 20%.
Conclusions: Women with history of genital herpes appear to have a slightly elevated risk of cesarean delivery, particularly in hospital settings with baseline prevalence of primary cesarean delivery above 20%. This rate is somewhat lower than that noted in a previous survey, suggesting that practitioners are following standard guidelines. Evaluations of cesarean delivery for genital herpes in other states should be performed.