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  • Incidence and predictors of surgical site infection in women who are obese and give birth by elective caesarean section: A secondary analysis

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    Embargoed until: 2022-09-10
    File version
    Accepted Manuscript (AM)
    Author(s)
    Chaboyer, Wendy
    Ellwood, David
    Thalib, Lukman
    Kumar, Sailesh
    Mahomed, Kassam
    Kang, Evelyn
    Gillespie, Brigid M
    Griffith University Author(s)
    Kang, Evelyn P.
    Gillespie, Brigid M.
    Ellwood, David A.
    Thalib, Lukman
    Chaboyer, Wendy
    Year published
    2021
    Metadata
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    Abstract
    Background: Surgical site infection (SSI) after a caesarean section is of concern (CS) is of concern to both clinicians and women themselves. Aims: The aim of this study is to identify the cumulative incidence and predictors of SSI in women who are obese and give birth by elective CS. Materials and Methods: The method used was planned secondary analysis of data from women with a pre-pregnancy body mass index (BMI) ≥30 kg/m2 giving birth by elective CS in a multicentre randomised controlled trial of a prophylactic closed-incision negative pressure wound therapy dressing. Data were collected from medical records, direct ...
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    Background: Surgical site infection (SSI) after a caesarean section is of concern (CS) is of concern to both clinicians and women themselves. Aims: The aim of this study is to identify the cumulative incidence and predictors of SSI in women who are obese and give birth by elective CS. Materials and Methods: The method used was planned secondary analysis of data from women with a pre-pregnancy body mass index (BMI) ≥30 kg/m2 giving birth by elective CS in a multicentre randomised controlled trial of a prophylactic closed-incision negative pressure wound therapy dressing. Data were collected from medical records, direct observations of the surgical site and self-reported signs and symptoms from October 2015 to December 2019. The Centers for Disease Control and Prevention definition was used to identify SSI. Women were followed up once in hospital just before discharge and then weekly for four weeks after discharge. Blinded outcome assessors determined SSI. After the cumulative incidence of SSI was calculated, multiple variable logistic regression models were used to identify independent risk factors for SSI. Results: SSI incidence in 1459 women was 8.4% (122/1459). Multiple variable-adjusted odds ratios (OR) for SSI were BMI ≥40 kg/m2 (OR 1.55, 95% confidence interval (CI) 1.30–1.86) as compared to BMI 30–34.9 0 kg/m2, ≥2 previous pregnancies (OR 1.38, 95% CI 1.00–1.80) as compared to no previous pregnancies and pre-CS vaginal cleansing (OR 0.55, 95% CI 0.33–0.99). Conclusions: Our findings may inform preoperative counselling and shared decision-making regarding planned elective CS for women with pre-pregnancy BMI ≥30 kg/m2.
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    Journal Title
    Australian and New Zealand Journal of Obstetrics and Gynaecology
    DOI
    https://doi.org/10.1111/ajo.13428
    Funder(s)
    NHMRC
    Grant identifier(s)
    APP1081026
    Note
    This publication has been entered in Griffith Research Online as an advanced online version.
    Subject
    Public health
    Paediatrics
    Science & Technology
    Life Sciences & Biomedicine
    Obstetrics & Gynecology
    caesarean section
    obesity
    Publication URI
    http://hdl.handle.net/10072/408322
    Collection
    • Journal articles

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