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

Abstract

We aimed to determine the incidence of surgical site infection (SSI) after cesarean delivery (CD) and identify the risk factors in a rural population. 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. The incidence of SSI after CD was 7.0%. Risk factors included higher body mass index (BMI) [40.30±10.60kg/m2 SSI (95% CI 38.73-41.87) vs 34.05±8.24kg/m2 control (95% CI 33.75-34.35, P<0.001)], years of education [13.28±2.44years SSI (95% CI 12.9-13.66) vs 14.07±2.81years 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). 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.