Surgical Site Infection Risk in Patients With Superobesity Undergoing Cesarean Delivery [ID: 1377550

Abstract

INTRODUCTION: Studies have reported increasing surgical site infection rates with increases in body mass index (BMI). Given a recent increase in the prevalence of BMI of 50 or higher across the United States, we sought to determine the association between incremental increases in BMI and the risk of surgical site infections. METHODS: This represents an IRB-approved single-institution retrospective cohort of patients with superobesity who underwent cesarean delivery from 2019 to 2022. The patient population is composed of predominantly underserved Black women receiving care at a safety net hospital serving a tri-state area in the mid-South. SPSS was utilized for data analysis to assess associations between variables. Covariate analysis was performed with logistic regressions. RESULTS: A total of 246 patients were included in the analysis. Patients were predominantly Black (84%, n=204) with public insurance (88.5%, n=201), and a median age of 30. Patients had a median BMI of 54. The median surgical site infection rate was found to be 11.8% (n=29). Surgical site infection rate in Pfannenstiel versus vertical was 7.4% (n=14) versus 16% (n=23.2) (odds ratio 2.29, P=.01). Surgical infection risk was 6.1% in BMI 40–49, 12.7% in patients with superobesity with BMI higher than 50, and 18.3% in patients with BMI higher than 60. CONCLUSION: Our study found that increasing increments of obesity are associated with increased morbidity. Regardless of incision type, surgical site infection rates are high in BMI greater than 60. A diagnosis of preeclampsia and reported allergy to antibiotics were found to exacerbate the risk for infection. This relationship warrants further investigation on interventions to mitigate these risks.