Risk of cesarean wound complications in diabetic gestations

• Published in: American journal of obstetrics and gynecology 2004-09, Vol.191 (3), p.958-963
• Main Authors: Takoudes, Tamara C., Weitzen, Sherry, Slocum, Julie, Malee, Maureen
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Body Mass Index; Cesarean delivery; Cesarean Section - adverse effects; Cohort Studies; Diabetes; Diabetic Nephropathies - complications; Diabetic Nephropathies - epidemiology; Diabetic Retinopathy - complications; Diabetic Retinopathy - epidemiology; Female; Gynecology. Andrology. Obstetrics; Humans; Hypertension - complications; Hypertension - epidemiology; Logistic Models; Medical sciences; Odds Ratio; Postoperative Complications; Pregnancy; Pregnancy in Diabetics - complications; Retrospective Studies; Risk Factors; Surgical Wound Dehiscence - epidemiology; Surgical Wound Infection - epidemiology; Wound complications; Wound infection
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2004.05.063

This study was undertaken to examine the association between pregestational diabetes mellitus (DM) and wound complications after cesarean delivery (CD). This was a retrospective, observational cohort study in patients with type 1 and 2 DM compared with non-DM controls undergoing CD. Wound complications were defined as wound infection, wound separation greater than 1 cm, and wound dehiscence. There was an overall incidence of wound complications of 18.4% (34/185) in DM versus 5.8% (10/174) in non-DM (unadjusted odds ratio of 3.7; 95% CI = 1.8-7.7). Mean body mass index before pregnancy was 30.9 in DM versus 26.5 kg/m 2 in non-DM ( P < .01). A multivariable logistic regression model adjusting for body mass index, length of surgery, and previous CD demonstrated a 2.5-fold increased risk of wound complications in DM patients compared with non-DM patients (95% CI = 1.1-5.5). Pregestational diabetes is associated with a 2.5-fold increase in wound complications after CD.