Schneid-Kofman N, Sheiner E, Levy A, Holcberg G
Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O. Box 151, Beer-Sheva, Israel.
Int J Gynaecol Obstet. 2005 Jul;90(1):10-5. doi: 10.1016/j.ijgo.2005.03.020.
To identify risk factors for early wound infection (diagnosed prior to discharge) following cesarean delivery.
A population-based study comparing women who have and have not developed a wound infection prior to discharge from Soroka University Medical Center, Ben Gurion University of the Negev, between 1988 and 2002.
Of the 19,416 cesarean deliveries performed during the study period, 726 (3.7%) were followed by wound infection. Using a multivariable logistic regression model, the following risk factors were identified: obesity (odds ratio [OR] = 2.2; 95% confidence interval [CI], 1.6-3.1); hypertensive disorders (OR = 1.7; 95% CI, 1.4-2.1); premature rupture of membranes (OR = 1.5; 95% CI, 1.2-1.9); diabetes mellitus (OR = 1.4; 95% CI, 1.1-1.7); emergency cesarean delivery (OR = 1.3; 95% CI, 1.1-1.5); and twin delivery (OR = 1.6; 95% CI, 1.3-2.0). Combined obesity and diabetes (gestational and pregestational) increased the risk for wound infection 9.3-fold (95% CI, 4.5-19.2; P < .001).
Independent risk factors for an early wound infection are obesity, diabetes, hypertension, premature rupture of membranes, emergency cesarean delivery, and twin delivery. Information regarding higher rates of wound infection should be provided to obese women undergoing cesarean delivery, especially when diabetes coexists.
确定剖宫产术后早期伤口感染（出院前诊断）的危险因素。
一项基于人群的研究，比较了1988年至2002年期间在本古里安大学内盖夫分校索罗卡大学医学中心出院前发生和未发生伤口感染的女性。
在研究期间进行的19416例剖宫产中，726例（3.7%）发生了伤口感染。使用多变量逻辑回归模型，确定了以下危险因素：肥胖（比值比[OR]=2.2；95%置信区间[CI]，1.6 - 3.1）；高血压疾病（OR = 1.7；95% CI，1.4 - 2.1）；胎膜早破（OR = 1.5；95% CI，1.2 - 1.9）；糖尿病（OR = 1.4；95% CI，1.1 - 1.7）；急诊剖宫产（OR = 1.3；95% CI，1.1 - 1.5）；以及双胎分娩（OR = 1.6；95% CI，1.3 - 2.0）。肥胖与糖尿病（妊娠期和孕前）合并使伤口感染风险增加9.3倍（95% CI，4.5 - 19.2；P <.001）。
早期伤口感染的独立危险因素是肥胖、糖尿病、高血压、胎膜早破、急诊剖宫产和双胎分娩。应向接受剖宫产的肥胖女性提供有关伤口感染率较高的信息，尤其是当合并糖尿病时。
