Surgical site infection following cesarean deliveries: trends and risk factors.
OBJECTIVE
To identify trends and risk factors for early surgical site infection (SSI) following cesarean delivery (CD).


METHODS
A population-based study comparing characteristics of women who have and have not developed post cesarean SSI was conducted. Deliveries occurred between the years 1988 and 2013 in a tertiary medical center. A multivariable logistic regression model, with backwards elimination, was used to control for confounders.


RESULTS
Of the 41 375 cesarean deliveries performed during the study period, 1521 (3.7%) were complicated with SSI. SSI rates significantly deceased over the years, from 7.4% in 1988 to 1.5% in 2012. Using a multivariable regression model, the following independent risk factors for SSI were identified: obesity (OR 2.0; 95% CI, 1.6-2.5); previous CD (OR 1.8; 95% CI, 1.6-2.0); hypertensive disorders (OR 1.4; 95% CI, 1.2-1.6); premature rupture of membranes (OR 1.3; 95% CI, 1.1-1.6); gestational diabetes mellitus (GDM, OR 1.2; 95% CI, 1.1-1.4); and recurrent pregnancy losses (OR 1.2; 95% CI, 1.1-1.5).


CONCLUSION
Independent risk factors for post-cesarean SSI include obesity, GDM, hypertensive disorders of pregnancy, premature rupture of membranes, and recurrent pregnancy losses. Information regarding higher rates of SSI and preventative measures should be provided to these high-risk women prior to surgery.
['Krieger|Yuval|Y|', 'Walfisch|Asnat|A|', 'Sheiner|Eyal|E|']
D000328:Adult D002585:Cesarean Section D005260:Female D006801:Humans D007557:Israel D016015:Logistic Models D011247:Pregnancy D012189:Retrospective Studies D012307:Risk Factors D013530:Surgical Wound Infection
surgical site infection risk factors Cesarean scar cesarean section wound infection