Cesarean Section Wound Infections and Neonatal Outcomes [8A

Abstract

INTRODUCTION: Cesarean section wound infections and adverse neonatal outcomes share similar risk factors. This study attempted to evaluate if the two events are correlated. METHODS: Patients undergoing cesarean section deliveries at University Health from 12/2013 to 12/2014 were identified. Common risk factors for wound complication, the occurrence of cesarean section wound complications, and neonatal outcomes were recorded and compared. Fisher’s exact test and two-sample Student's t-test were used to determine if correlations between wound complications and neonatal outcomes were significant, and if the presence of risk factors differed among those with and without wound infections and adverse neonatal outcomes. RESULTS: Included in the study were 490 women with no wound complications, 36 with wound infection, and 54 with wound breakdown without evidence of infection. The occurrence of any wound complication was associated with the occurrence of adverse neonatal outcomes (P=.008, OR 1.89 [95% CI 1.17–3.07]). Wound breakdown was correlated with pregnancy-induced hypertension (P=.01, OR 2.58 [95% CI 1.20–5.29]), while infection was associated with pre-gestational diabetes (P=.02, OR 3.98 [95% CI 1.09–12.04]), and higher BMI (44.8 kg/m2 vs 37.1 kg/m2, P=.0008). Having greater than two risk factors was correlated with having concurrent wound complication and adverse neonatal outcome (P=.001, OR 9.12 [95% CI 2.4–33.3]). CONCLUSION: This study finds that women with a cesarean section wound complication are at a higher risk for complications related to the neonate as well. Counseling of women with multiple risk factors should include the possibility of both maternal and neonatal morbidity.