Postdischarge surveillance following cesarean section: the incidence of surgical site infection and associated factors.
BACKGROUND
The rate of surgical site infections (SSI) and their associated risk factors was identified by performing postdischarge surveillance following cesarean section at a public university teaching hospital in Brazil.


METHODS
The study was conducted at the Center for Women's Integrated Health Care in Brazil between May 2008 and March 2009. Women were contacted by telephone 15 and 30 days after cesarean section. During hospitalization, a form was completed on factors associated with post-cesarean SSI. The chi(2) test and Fisher exact test were used to analyze categorical variables and the Mann-Whitney test for numerical variables. Relative risks (RR) and their respective 95% confidence intervals (95% CI) were calculated for factors associated with SSI. P values < .05 were considered significant.


RESULTS
The final sample consisted of 187 women. SSI was detected in 44 cases (23.5%). In 42 of 44 women (95%), SSI appeared following discharge from hospital, becoming evident within the first 15 days following surgery. Number of prenatal consultations < or =7 (RR, 2.09; 95% CI: 1.26-3.48) and hypertension (RR, 2.07; 95% CI: 1.25-3.43) were significantly associated with SSI in the bivariate analysis. In the multivariate analysis, only hypertension (RR, 2.47; 95% CI: 1.21-5.04) remained significant.


CONCLUSIONS
Postdischarge surveillance is essential for ensuring accurate estimates of post-cesarean section SSI. A 15-day postdischarge follow-up was shown to be sufficient. Hypertension was a factor associated with SSI.
Cardoso Del Monte
Meire Celeste
MC
Department of Infection Control, Women's Hospital, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil. meiredelmonte@yahoo.com
Pinto Neto
Aarão Mendes
AM
D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult