Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center

Abstract

Background

We aimed to determine the incidence of surgical site infection (SSI) after cesarean delivery (CD) and identify the risk factors in a rural population.

Methods

We identified 218 SSI patients by International Classification of Disease codes and matched them with 3131 parturients (control) from the electronic record database in a time-matched retrospective quality assurance analysis.

Results and discussion

The incidence of SSI after CD was 7.0 %. Risk factors included higher body mass index (BMI) [40.30 ± 10.60 kg/m² SSI (95 % CI 38.73–41.87) vs 34.05 ± 8.24 kg/m² control (95 % CI 33.75–34.35, P < 0.001)], years of education [13.28 ± 2.44 years SSI (95 % CI 12.9–13.66) vs 14.07 ± 2.81 years control (95 % CI 13.96–14.18, P < 0.001)], number of prior births [2 (1–9) SSI vs 1 (1–11) control (P < 0.001)], tobacco use (OR 1.49; 95 % CI 1.06–2.09, P = 0.03), prior diagnosis of hypertension (OR 1.80; 95 % CI 1.34–2.42, P < 0.001), gestational diabetes (OR 1.59; 95 % CI 1.18–2.13, P = 0.003), and an emergency/STAT CD (OR 1.6; 95 % CI 1.1–2.3, P = 0.01).

Conclusions

Risk factors for SSI after CD included higher BMI, less years of education, higher prior births, tobacco use, prior diagnosis of hypertension, gestational diabetes, and emergency/STAT CD. The presence of ruptured membranes was protective against SSI.

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