1125 The impact of operative times on postpartum infectious morbidities: a study of extremes

Abstract

Increased risk of postpartum (PP) infection among women with operative complications is well described. However, the specifics of these risks are less well understood at the extremes of operative time (OT). The objective of this study was to evaluate the impact of increased OT on infectious morbidity and wound complications during the PP period. Secondary analysis of women in the MFMU Cesarean Registry who underwent cesarean delivery. Primary outcome was any PP infectious morbidity including endometritis and wound infection. Secondary outcomes included wound complication infection prior to delivery discharge, readmission for wound complication, and wound infection. Bivariate statistics used to compare baseline demographics, pregnancy complications, and primary outcomes among women by increasing OT groups (95th%). Regression modeling used to estimate odds of outcomes. Of 37434 women included, 18740(50.0%) with OT95th% (>88m). BMI and rates of prior CS, diabetes, Black race, Medicaid, intrapartum antibiotic use, and use of general anesthesia all increased with increasing OT (Table 1). Rates of PP infectious complications increased with increasing OT, driven by endometritis (Table 2). Readmission wound complications did not differ, but inpatient wound complications and endometritis did increase with OT (Table 2). After adjusting for confounders, compared to women with OT95%, Table 2). Adjusted odds of readmission for wound complication was not significant (Table 2). Women at longer OT appear to be at a slightly increased risk of endometritis and inpatient wound complications compared to women with OT<50th%. These data reinforce the importance of surgical site infection prevention bundles.View Large Image Figure ViewerDownload Hi-res image Download (PPT)