Open AccessObesity, diabetes, and the risk of infections diagnosed in hospital and post‐discharge infections after cesarean section: a prospective cohort study
Author(s) -
LETH RITA ANDERSEN,
ULDBJERG NIELS,
NØRGAARD METTE,
MØLLER JENS KJØLSETH,
THOMSEN REIMAR WERNICH
Publication year - 2011
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2011.01090.x
Subject(s) - medicine , gestational diabetes , body mass index , odds ratio , type 2 diabetes , prospective cohort study , diabetes mellitus , pregnancy , obesity , population , obstetrics , cohort study , confidence interval , gestation , endocrinology , genetics , biology , environmental health
Objective. To assess the impact of obesity and diabetes on the risk of post‐cesarean infections. Design. Prospective cohort study. Setting. Obstetric departments at three hospitals in Denmark. Population. 2,492 consecutive women having cesarean section (CS) from February 2007 to August 2008. Methods. We collected complete data from medical records and databases on CS, body mass index, diabetes (type 1, type 2, and gestational), and post‐cesarean infections. Post‐discharge infections diagnosed by general practitioners were ascertained through positive microbiological cultures and antibiotic prescriptions. Main Outcome Measures. Cumulative incidences of infections within 30 days after CS. Results. Of 2,492 women having CS, 373 (15.2%) were obese and 123 (4.9%) had diabetes. Overall, 458 women (18.4%) had a post‐cesarean infection within 30 days and 174 (7.0%) were diagnosed in‐hospital. The risk of post‐cesarean infections was higher among obese than non‐obese women: adjusted (for diabetes and emergency/elective CS) odds ratio (OR)=1.43; 95% confidence interval (CI): 1.09–1.88, particularly for in‐hospital infections (OR=1.86; 95%CI: 1.28–2.72). After controlling for obesity and mode of CS, type 2 or gestational diabetes were weak predictors of infection risk (OR=1.18; 95%CI: 0.72–1.93), whereas the adjusted OR in women with type 1 diabetes was 1.65 (95%CI: 0.64–4.25). Among diabetic women, obesity increased the risk of post‐cesarean infections more than twofold; the adjusted ORs were 2.06 (95%CI: 1.13–3.75) for infections overall and 2.74 (95%CI: 1.25–6.01) for in‐hospital infections. Conclusion. Obesity increases the risk of post‐cesarean infections and diabetes further strengthens this association.