title: Association of smoking with wound complications after cesarean delivery.
abstract: OBJECTIVE
  To determine whether smoking is an independent risk factor for wound dehiscence after cesarean delivery.
  
  
  METHODS
  In this case-control study, medical records were reviewed for all patients with wound dehiscence after cesarean delivery during a 7-month period. Wound dehiscence was defined as separation of wound edges requiring treatment. Three control patients without such complications were randomly selected for each case patient. Univariate associations were assessed using t test or Fisher's exact test; univariate odds ratios (OR) and 95% confidence intervals (CI) were calculated with logistic regression. Multivariate associations were assessed with logistic regression on variables with a univariate association significant at p ≤ 0.10.
  
  
  RESULTS
  Of 597 cesarean deliveries, 30 cases (5 %) with wound dehiscence were identified. As individual variables, smoking (46.7 vs. 21.1%, p < 0.01, cases vs. controls), histological chorioamnionitis (27.6 vs. 6.7%, p < 0.01) and preoperative hematocrit (34.0 ± 3.2 vs. 35.4 ± 3.4, p < 0.05) were significantly associated with wound complications. In a multivariate logistic regression model, only smoking (OR 5.32; 95% CI 1.77-15.97, p < 0.01) and histological chorioamnionitis (OR 5.62; 95% CI 1.43-22.11, p < 0.01) were independently associated with wound dehiscence.
  
  
  CONCLUSIONS
  Smoking and histological chorioamnionitis are independently associated with wound dehiscence after cesarean delivery.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, Division of Maternal-Fetal Medicine, Stony Brook University, Stony Brook, NY 11794-8091, USA. cecilia.avila@sbumed.org
authors.forename: Cecilia
authors.initials: C
authors.lastname: Avila
authors.forename: Rupinder
authors.initials: R
authors.lastname: Bhangoo
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Figueroa
authors.forename: Jarrett
authors.initials: J
authors.lastname: Santorelli
authors.forename: Paul
authors.initials: P
authors.lastname: Ogburn
authors.forename: Paul H
authors.initials: PH
authors.lastname: Desan
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects / Q000534:rehabilitation / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000534:rehabilitation / Q000706:statistics & numerical data; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000209:etiology*; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult