Risk factors for postcesarean surgical site infection.
OBJECTIVE
To determine postcesarean complications and identify independent risk factors for surgical site infection.


METHODS
We studied a cohort of 969 women delivered by cesarean between May and August 1997. Infections were determined by examinations during ward rounds, reviews of laboratory results, and follow-up for 30 days after discharge. Risk factors were identified by multiple logistic regression.


RESULTS
Surgical complications were rare. There were febrile morbidity and infection complications in 16.2% and 12.4% of subjects, respectively. Eighty-five subjects had 95 surgical site infections (9.8%), and seven risk factors were independently associated with infection. Risk factors included preoperative remote infection (adjusted odd ratio [OR] 16.5, 95% confidence interval [CI] 2.1, 128.3); chorioamnionitis (OR 10.6, 95% CI 2.1, 54.2); maternal preoperative condition (OR 5.3 for those with severe systemic disease [American Society of Anesthesiologists score > or =31, 95% CI 1.2, 24.0); preeclampsia (OR 2.3, 95% CI 1.1, 4.9); higher body mass index (OR 2.0 for every five-unit increment, 95% CI 1.3, 3.0); nulliparity (OR 1.8, 95% CI 1.1, 3.2); and increased surgical blood loss (OR 1.3 for every 100-mL increment, 95% CI 1.1, 1.5).


CONCLUSIONS
Host susceptibility and existing infections were important predictors of surgical site infection after cesarean delivery. Further intervention should target this high-risk group to reduce the clinical effect of surgical site infection.
Tran
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TS
Hungvuong Obstetric and Gynecological Hospital, Ho Chi Minh City, Vietnam. transon_thach@hotmail.com
Jamulitrat
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Chongsuvivatwong
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Geater
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A
D000328:Adult; D016063:Blood Loss, Surgical; D002585:Cesarean Section / Q000009:adverse effects*; D002821:Chorioamnionitis / Q000453:epidemiology; D015897:Comorbidity; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology