Objective: To identify risk factors associated with post-cesarean infectious morbidity after antibiotic prophylaxis
Design: Analytic retrospective study
Materials and methods: Population-based sample of 1,000 pregnant women who underwent cesarean section at Hatyai Regional Hospital during January 1, 1998 through February 28, 1999. Only 755 pregnant women given single-dose ampicillin 2 g or cefazolin 1 g prophylaxis after umbilical cord clamping were included in the study.
Results: Ampicillin or cefazolin prophylaxis was given in 81.2% and 18.8% of the patients, respectively. Only 2.8% of the patients had post-cesarean infectious morbidity. Adjusted odds ratio of developing infectious morbidity was reduced by appro- ximately half when surgeons were staff compared to trainee surgeons [OR = 0.44, 95%CI = 0.2-0.9]. A higher infection rate was related to the trainee surgeons and duration of surgery of 90 minutes or longer [OR = 7.5, 95%CI = 2.5-22.4]. Anemic status, gestational age, indication for cesarean section, duration of labor or ruptured membranes and number of vaginal examinations were not statistically significant risk factors.
Conclusion: The rate of post-cesarean infectious morbidity after single-dose ampicillin or cefazolin prophylaxis was low. Only two significant modifiable risk factors have the possibility to be changed through interventions: less skilled surgeons and surgery time of more than 90 minutes.