Incidence and risk factors of surgical site infection following cesarean section: a prospective cohort study at Jimma university medical center

Surgical site infection (SSI) after cesarean section (CS) is one of the contributors for high maternal mortality and morbidity rates.

This prospective cohort analysis assessed the incidence rate and risk factors of time to SSI following CS among women who were admitted to Jimma University Medical Center (JUMC).

Data was gathered from CS patients who were admitted to the maternity ward at JUMC. The study included women who were admitted to the JUMC maternity ward, had CS, and agreed to participate. The study excluded women who died soon after or during the CS surgery. 417 of the 1,081 women who had CS throughout the study period fulfilled the criteria. We have used the Kaplan-Meir estimator and the Cox proportional hazard model for the analysis and model building.

The study included 417 women out of 1,081 who underwent CS between March and August 2022. The incidence rate for SSI following CS among women was 19.7%. The survival curve shows that the contaminated and dirty wound classification have significantly lower survival rates than other surgical wound classifications. The Cox proportional model result indicates; body mass index (BMI) (HR: 1.08, 95% CI: 1.01-1.15), time to give antibiotic prophylaxis (HR: 1.03, 95%CI: 1.01- 1.06), duration of operation (HR: 1.02, 95% CI: 1.01- 1.03), admission status (HR: 1.65, 95% CI: 1.05 -2.59), and duration of labor (HR: 1.04, 95% CI: 1.01- 1.08) (HR: 1.08, 95% CI: 1.01-1.15), time to give antibiotic prophylaxis (HR: 1.03, 95% CI: 1.01- 1.06), duration of operation (HR: 1.02, 95% CI: 1.01- 1.03), admission status (HR: 1.65, 95% CI: 1.05 -2.59), and duration of labor (HR: 1.04, 95% CI: 1.01- 1.08) covariates are significant at a 5% level of significance.

The magnitude of SSI following CS is high. The duration of labor, BMI, procedure time, and the timing of treatment were risk factors of SSI after CS. Women with a high BMI and referring-admitted patients should also receive extra care. Therefore, strict treatment is required, along with close observation and follow-up. Finally, increased awareness of these risk factors, continuous training in infection prevention techniques may minimize and prevent the high SSI rate after CS. Furthermore, to effectively prevent surgical site infections (SSIs) in cesarean section (CS) patients, action-oriented measures such as strengthening antibiotic prophylactic guidelines and enhancing surveillance of vulnerable women are essential.

Not applicable.