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

Background: This study explored the correlation between maternal serum albumin levels prior to elective 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 ≤ 3.4 g/dL or > 3.4 g/dL were compared. Results: Among 796 women admitted for an elective CD, 537 met the inclusion criteria. There were 356 (66.3%) women in the low albumin level group (≤ 3.4 g/dL) and 181 (33.7%) with serum albumin level > 3.4 g/dL. Patients with serum albumin >3.4 g/dL had increased rates of SSI (6.1% vs. 2.5% respectively; p=0.04), need for antibiotics during the post-partum period (13.3% vs 4.2%, respectively; p<0.001), surgical intervention (5% vs. 1%, respectively; p=0.02) and rehospitalization rate (7.2% vs. 0.8%, respectively; p<0.001). Multivariant analysis showed albumin level >3.4 g/dL was independently associated with composite postoperative, maternal adverse 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.