Guo Li, Huang Shujuan, Sui Hongmei, Li Weichao
Department of Obstetrics, Beichen Traditional Chinese Medicine Hospital Affiliated to Tianjin University of Traditional Chinese Medicine, Tianjin, P.R. China.
Department of Infectious Diseases, Tianjin, P.R. China.
J Obstet Gynaecol Res. 2025 Jan;51(1):e16172. doi: 10.1111/jog.16172.
This study aims to estimate the overall incidence of surgical site infections (SSIs) after cesarean section (CS) and the influencing factors in the Chinese population.
The study searched all relevant literature in English and Chinese search databases (English search bases: PubMed, Embase, Cochrane Library, Web of Science; Chinese search bases: China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Database) up to March 19, 2024, according to the search strategy. A random/fixed effects model was decided on the basis of the I statistic assessing the magnitude of study heterogeneity, and publication bias was assessed using the Begg's test.
After the selection, a final selection of 25 articles was involved. The estimate of post-CS SSIs in China was 2.4% (95%CI: 0.019, 0.029). Age ≥30 years (WMD: 3.8), pre-pregnancy body mass index (BMI) ≥25 kg/m (WMD: 1.8), obesity (odds ratio [OR]: 3.0), vaginal cleanliness 3-4 (OR: 4.2), anemia (OR: 1.4), premature rupture of membranes (OR: 2.6), diabetes mellitus (OR: 2.7), National Nosocomial Infections Surveillance System 1-3 (OR: 5.6), emergency surgery (OR: 2.3), trial of labor (OR: 2.9), duration of surgery ≥60 min (OR: 2.0), and intraoperative blood loss >500 mL (OR: 3.5) were the risk factors for post-CS SSIs.
The rate of post-CS SSIs estimated was 2.4% in China. Both maternal conditions and surgical factors can potentially increase the risk of post-CS SSIs.
本研究旨在评估中国人群剖宫产术后手术部位感染（SSIs）的总体发生率及其影响因素。
本研究按照检索策略，检索了截至2024年3月19日英文和中文检索数据库中的所有相关文献（英文检索库：PubMed、Embase、Cochrane图书馆、Web of Science；中文检索库：中国知网、万方、中国科技期刊数据库）。根据评估研究异质性大小的I统计量确定采用随机/固定效应模型，并使用Begg检验评估发表偏倚。
筛选后，最终纳入25篇文章。中国剖宫产术后手术部位感染的估计发生率为2.4%（95%CI：0.019，0.029）。年龄≥30岁（加权均数差[WMD]：3.8）、孕前体重指数（BMI）≥25kg/m²（WMD：1.8）、肥胖（比值比[OR]：3.0）、阴道清洁度3-4度（OR：4.2）、贫血（OR：1.4）、胎膜早破（OR：2.6）、糖尿病（OR：2.7）、国家医院感染监测系统1-3级（OR：5.6）、急诊手术（OR：2.3）、试产（OR：2.9）、手术时间≥60分钟（OR：2.0）以及术中失血>500mL（OR：3.5）是剖宫产术后手术部位感染的危险因素。
中国剖宫产术后手术部位感染的估计发生率为2.4%。产妇状况和手术因素均可能增加剖宫产术后手术部位感染的风险。
