Case Control Study to Assess Independent Risk Factors Influencing Surgical Site Infection after Cesarean Section

Abstract

Objective: The objectives of the present study were to determine independent risk factors (Patient, Obstetrics, Operation related variables) for surgical site infection after caesarean section. Study design: A case control study. Place: A teaching hospital: J N Medical College, Belgaum. Sample size: 1050 (350 cases, 700 controls). Results: A total of 1050 womens were devided into cases (350) and controls (700). The outcome for analysis was based on the independent risk factor for surgical site infection. In this study the independent risk factors found to be significant were GDM(oddsratio5.4, p value of 0.0001), HIV (p value 0.001,anemia (odds ratioof 10.66, p value of0.0001), unregistered antenatal cases (odds ratio of 4.7, p value of <0.0001), primary caesarean section (odds ratio of 5, p value 0.0001), PROM( odds ratio 7.4, p value 0.0001), chorioamnionitis ( p value 0.04), preeclampsia/ eclampsia (odds ratioof 7.90, p value of 0.0001), induction of labour (odds ratio8.46, p value 0.0001), meconium stained liquor (odds ratio of 5.1, p value 0.0001), emergency caesarean section ( odds ratio of 9.6, p value of <0.0001), conservative surgery for PPH( odds ratio of 14.2, p value of 0.01), peripartum hysterectomy ( odds ratio of 30.54, p value of 0.01). The factors which were not significantly associated with SSI are age, gestational age, gravida, APH, prophylactic antibiotics. Conclusion and interpretation: The present study showed that following were independent risk factors for SSI, gestational diabetes, HIV, haemoglobin between 9-11gm%, Unregistered antenatal cases, Primary cesarean section, pereclampsia/ eclampsia, induction of labour, PROM, chorioamnionitis, meconium stained liquor, emergency cesarean section, conservative surgery for PPH, were found to be significant.