Abstract Title:

Risk of selected postpartum infections after cesarean section compared with vaginal birth: A five-year cohort study of 32,468 women.

Abstract Source:

Acta Obstet Gynecol Scand. 2009 Jul 29:1-8. Epub 2009 Jul 29. PMID: 19642043

Abstract Author(s):

Rita Andersen Leth, Jens Kjølseth Møller, Reimar Wernich Thomsen, Niels Uldbjerg, Mette Nørgaard

Article Affiliation:

Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N, Denmark.

Abstract:

Objectives. To compare the risk of postpartum infections within 30 days after vaginal birth, emergency, or elective cesarean section (CS). Design. Register-based cohort study in Denmark. Participants. A total of 32,468 women giving birth in hospitals in the County of Aarhus, Denmark, during the period 2001-2005. Methods. Data from various hospital registries were combined and infections were identified by positive cultures, prescriptions for antibiotics and, re-operative procedures. Risk of postpartum infection was estimated and adjustment for potentially confounders was performed. Results. Within 30 days postpartum, 7.6% of women who had underwent CS and 1.6% of women having a vaginal birth acquired an infection, yielding an adjusted odds ratio (OR) of 4.71, 95% confidence interval (CI): 4.08-5.43. The prevalence of postpartum urinary tract infection (UTI) was 2.8%, after CS and 1.5% after vaginal birth corresponding to an adjusted OR = 1.68, 95% CI: 1.38-2.03. The risk of UTI did not differ between emergency and elective CS. The prevalence of WI was 5.0% after CS and 0.08% after vaginal birth. Moreover, we found a nearly 50% higher risk of postpartum WI after emergency CS compared to elective CS (OR = 1.49, 95% CI: 1.13-1.97). More than 75% (697/907) of postpartum infections appeared after hospital discharge. Conclusions. The risk of postpartum infection seems to be nearly five-fold increased after CS compared with vaginal birth. This may be of concern since the prevalence of CS is increasing.

Study Type : Meta Analysis

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