American Journal of Obstetrics & Gynecology
Volume 191, Issue 3 , Pages 958-963, September 2004

Risk of cesarean wound complications in diabetic gestations

  • Tamara C. Takoudes, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine,
    • Corresponding Author InformationReprint request: Tamara C. Takoudes, Beth Israel Deaconess Medical Center, 330 Brookline Ave, KS3, Div of MFM, Boston, MA 02215.
    • ,
  • Sherry Weitzen, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, Division of Research, Brown University, Providence, RI
    • ,
  • Julie Slocum, MS

      Affiliations

    • Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine,
    • ,
  • Maureen Malee, MD, PhD

      Affiliations

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

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

 

 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

American Journal of Obstetrics & Gynecology
Volume 191, Issue 3 , Pages 958-963, September 2004