Meconium-Stained Amniotic Fluid is Associated With an Increased Risk of Post-Cesarean Surgical Site Infection [2OP

Abstract

INTRODUCTION: Surgical site infection (SSI) following a cesarean delivery is a common obstetrical problem with significant impact on maternal health. Several risk factors for SSI have been identified, such as chorioamnionitis and obesity. Meconium-stained amniotic fluid (MSAF) has been shown to increase the risk for peripartum infection; however, its impact on postpartum SSI is unclear. Here, we look at the correlation between MSAF and SSI post cesarean delivery. METHODS: We performed a secondary analysis using data from Maternal-Fetal Medicine Units Network (MFMU) Cesarean Registry of all women attempting labor or induction of labor with singleton pregnancies that ultimately had a cesarean section. A multivariable logistic regression model was used to control for confounders. RESULTS: Of the singleton pregnancies that ultimately had a cesarean delivery after a trial of labor, 5,883 had MSAF. Those with MSAF had a significantly increased incidence of surgical site infection (SSI) (11.5% vs 8.9%, P < .001). Even when controlling for confounding factors, including IUPC usage, race, smoking, diabetes, preeclampsia, PPROM, chorioamnionitis, prenatal care, labor length, rupture length, gestational age, BMI and ASA class, MSAF was still associated with SSI (OR 1.248 CI 1.118–1.393, P < .001). CONCLUSION: MSAF is associated with an increased risk of SSI following cesarean delivery. Further studies should be done to determine if patients with MSAF would benefit from closer monitoring of their wound postpartum to decrease the risk of severe morbidity associated with SSI.