Risk factors for wound infection following cesarean deliveries.
OBJECTIVE
To identify risk factors for early wound infection (diagnosed prior to discharge) following cesarean delivery.


METHODS
A population-based study comparing women who have and have not developed a wound infection prior to discharge from Soroka University Medical Center, Ben Gurion University of the Negev, between 1988 and 2002.


RESULTS
Of the 19,416 cesarean deliveries performed during the study period, 726 (3.7%) were followed by wound infection. Using a multivariable logistic regression model, the following risk factors were identified: obesity (odds ratio [OR] = 2.2; 95% confidence interval [CI], 1.6-3.1); hypertensive disorders (OR = 1.7; 95% CI, 1.4-2.1); premature rupture of membranes (OR = 1.5; 95% CI, 1.2-1.9); diabetes mellitus (OR = 1.4; 95% CI, 1.1-1.7); emergency cesarean delivery (OR = 1.3; 95% CI, 1.1-1.5); and twin delivery (OR = 1.6; 95% CI, 1.3-2.0). Combined obesity and diabetes (gestational and pregestational) increased the risk for wound infection 9.3-fold (95% CI, 4.5-19.2; P < .001).


CONCLUSIONS
Independent risk factors for an early wound infection are obesity, diabetes, hypertension, premature rupture of membranes, emergency cesarean delivery, and twin delivery. Information regarding higher rates of wound infection should be provided to obese women undergoing cesarean delivery, especially when diabetes coexists.
Schneid-Kofman
N
N
Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O. Box 151, Beer-Sheva, Israel.
Sheiner
E
E
Levy
A
A
Holcberg
G
G
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D009765:Obesity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012044:Regression Analysis; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control