Occurrence and risk factors for surgical site infection following
caesarean delivery: a hospital-based case-control study.
Abstract Objective To examine the occurrence and independent risk
factors for surgical site infection (SSI) after caesarean section (CS).
Design A hospital-based case-control study. Setting University Hospital.
Population Women who were readmitted with SSI after CS during the years
2014-2016 (n=75). Controls were selected at a ratio of 2:1 (n=148).
Methods Cases (women with SSI following CS) and controls (women without
SSI following CS) were compared with respect to maternal and pregnancy
characteristics using multivariable logistic regression analysis. Main
Outcome Measures Anticipated risk factors for SSI. Results The
occurrence of SSI requiring rehospitalisation was 0.38% and 5.5% after
elective and emergency CS, respectively. Obesity was four times more
common in women with SSI than in women without SSI (OR 4.1, 95% CI
1.5-11.3). Signs of infection during labour was almost five times more
common (OR 4.7, 95% CI 1.7-13.0). Attempted vaginal delivery by pushing
before CS was more than five times more common (OR 5.6, 95% CI
1.3-24.3). Pre-existing psychiatric disease was a significant predictor
for SSI. Conclusions Emergency CS was a significant characteristic for
SSI. Obesity, signs of infection prior to delivery, attempt of vaginal
delivery by pushing before CS and pre-existing psychiatric disease, were
independent risk factors for SSI. Women with either of these risk
factors should be carefully monitored and evaluated for signs of
infection in the postpartum period.