title: Surgical site infection following cesarean deliveries: trends and risk factors.
abstract: OBJECTIVE
  To identify trends and risk factors for early surgical site infection (SSI) following cesarean delivery (CD).
  
  
  METHODS
  A population-based study comparing characteristics of women who have and have not developed post cesarean SSI was conducted. Deliveries occurred between the years 1988 and 2013 in a tertiary medical center. A multivariable logistic regression model, with backwards elimination, was used to control for confounders.
  
  
  RESULTS
  Of the 41 375 cesarean deliveries performed during the study period, 1521 (3.7%) were complicated with SSI. SSI rates significantly deceased over the years, from 7.4% in 1988 to 1.5% in 2012. Using a multivariable regression model, the following independent risk factors for SSI were identified: obesity (OR 2.0; 95% CI, 1.6-2.5); previous CD (OR 1.8; 95% CI, 1.6-2.0); hypertensive disorders (OR 1.4; 95% CI, 1.2-1.6); premature rupture of membranes (OR 1.3; 95% CI, 1.1-1.6); gestational diabetes mellitus (GDM, OR 1.2; 95% CI, 1.1-1.4); and recurrent pregnancy losses (OR 1.2; 95% CI, 1.1-1.5).
  
  
  CONCLUSIONS
  Independent risk factors for post-cesarean SSI include obesity, GDM, hypertensive disorders of pregnancy, premature rupture of membranes, and recurrent pregnancy losses. Information regarding higher rates of SSI and preventative measures should be provided to these high-risk women prior to surgery.
authors.affiliation: a Department of Plastic Surgery , Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva , Israel , and.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Krieger
authors.affiliation: b Department of Obstetrics and Gynecology , Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva , Israel.
authors.forename: Asnat
authors.initials: A
authors.lastname: Walfisch
authors.affiliation: b Department of Obstetrics and Gynecology , Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva , Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*
keywords: Cesarean scar; cesarean section; risk factors; surgical site infection; wound infection