Risk of cesarean wound complications in diabetic gestations.
OBJECTIVE
This study was undertaken to examine the association between pregestational diabetes mellitus (DM) and wound complications after cesarean delivery (CD).


METHODS
This was a retrospective, observational cohort study in patients with type 1 and 2 DM compared with non-DM controls undergoing CD. Wound complications were defined as wound infection, wound separation greater than 1 cm, and wound dehiscence.


RESULTS
There was an overall incidence of wound complications of 18.4% (34/185) in DM versus 5.8% (10/174) in non-DM (unadjusted odds ratio of 3.7; 95% CI = 1.8-7.7). Mean body mass index before pregnancy was 30.9 in DM versus 26.5 kg/m 2 in non-DM (P < .01). A multivariable logistic regression model adjusting for body mass index, length of surgery, and previous CD demonstrated a 2.5-fold increased risk of wound complications in DM patients compared with non-DM patients (95% CI = 1.1-5.5).


CONCLUSIONS
Pregestational diabetes is associated with a 2.5-fold increase in wound complications after CD.
Department of Obstetrics and Gynecology, Brown University, Providence, RI, USA. tlc16@columbia.edu
Tamara C
TC
Takoudes
Sherry
S
Weitzen
Julie
J
Slocum
Maureen
M
Malee
D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section / Q000009:adverse effects*; D015331:Cohort Studies; D003928:Diabetic Nephropathies / Q000150:complications / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D016015:Logistic Models; D016017:Odds Ratio; D011183:Postoperative Complications; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology