Risk of cesarean wound complications in diabetic gestations

Objective

This study was undertaken to examine the association between pregestational diabetes mellitus (DM) and wound complications after cesarean delivery (CD).

Study design

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.

Results

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/m2 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).

Conclusion

Pregestational diabetes is associated with a 2.5-fold increase in wound complications after CD.

Key words: Wound complications, Wound infection, Diabetes, Cesarean delivery

a Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine,

b Department of Obstetrics and Gynecology, Division of Research, Brown University, Providence, RI

Reprint request: Tamara C. Takoudes, Beth Israel Deaconess Medical Center, 330 Brookline Ave, KS3, Div of MFM, Boston, MA 02215.

Support was provided by the Division of Maternal-Fetal Medicine, Brown University.

Presented as a poster at the Twenty-Fourth Annual Meeting of the Society of Maternal-Fetal Medicine in New Orleans, La, February 2-7, 2004.

PII: S0002-9378(04)00547-2

doi:10.1016/j.ajog.2004.05.063

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