Perioperative antibiotic prophylaxis for nonlaboring cesarean delivery

Mara J. Dinsmoor, Sharon Gilbert, Mark B. Landon, Dwight J. Rouse, Catherine Y. Spong, Michael W. Varner, Steve N. Caritis, Ronald J. Wapner, Yoram Sorokin, Menachem Miodovnik, Mary J. O'Sullivan, Baha M. Sibai, Oded Langer

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

OBJECTIVE: To estimate the efficacy of antibiotic prophylaxis at the time of nonlaboring cesarean delivery in reducing postpartum infection-related complications. METHODS: We performed a secondary analysis of an observational study of cesarean deliveries performed at 13 centers from 1999-2000. Patients were included if they had cesarean delivery before labor, did not have intrapartum infection, and were not given antibiotics at delivery for reasons other than prophylaxis. The occurrence of postpartum endometritis, wound infection, and other, less common infection-related complications was compared between those who did and did not receive antibiotic prophylaxis. Results were adjusted for smoking, payer status, gestational age and body mass index at delivery, race, diabetes, antepartum infections, presence of anemia, operative time, type of cesarean delivery (primary or repeat), and center. RESULTS: Of the 9,432 women who met study criteria, the 6,006 (64%) who received antibiotic prophylaxis were younger, heavier at delivery, and were more likely to be African American, receive public insurance, and have diabetes. Patients who received antibiotic prophylaxis were less likely to develop postpartum endometritis (121 [2.0%] compared with 88 [2.6%], adjusted odds ratio [OR] 0.40, 95% confidence interval [CI] 0.28-0.59) or wound infection (31 [0.52%] compared with 33 [0.96%], adjusted OR 0.49, 95% CI 0.28-0.86). CONCLUSION: Antibiotic prophylaxis at the time of nonlaboring cesarean delivery significantly reduces the risks of postpartum endometritis and wound infection.

Original languageEnglish
Pages (from-to)752-756
Number of pages5
JournalObstetrics and Gynecology
Volume114
Issue number4
DOIs
StatePublished - Oct 1 2009
Externally publishedYes

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Antibiotic Prophylaxis
Endometritis
Postpartum Period
Wound Infection
Infection
Odds Ratio
Confidence Intervals
Operative Time
Insurance
African Americans
Gestational Age
Observational Studies
Anemia
Body Mass Index
Smoking
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Dinsmoor, M. J., Gilbert, S., Landon, M. B., Rouse, D. J., Spong, C. Y., Varner, M. W., ... Langer, O. (2009). Perioperative antibiotic prophylaxis for nonlaboring cesarean delivery. Obstetrics and Gynecology, 114(4), 752-756. https://doi.org/10.1097/AOG.0b013e3181b8f28f

Perioperative antibiotic prophylaxis for nonlaboring cesarean delivery. / Dinsmoor, Mara J.; Gilbert, Sharon; Landon, Mark B.; Rouse, Dwight J.; Spong, Catherine Y.; Varner, Michael W.; Caritis, Steve N.; Wapner, Ronald J.; Sorokin, Yoram; Miodovnik, Menachem; O'Sullivan, Mary J.; Sibai, Baha M.; Langer, Oded.

In: Obstetrics and Gynecology, Vol. 114, No. 4, 01.10.2009, p. 752-756.

Research output: Contribution to journalArticle

Dinsmoor, MJ, Gilbert, S, Landon, MB, Rouse, DJ, Spong, CY, Varner, MW, Caritis, SN, Wapner, RJ, Sorokin, Y, Miodovnik, M, O'Sullivan, MJ, Sibai, BM & Langer, O 2009, 'Perioperative antibiotic prophylaxis for nonlaboring cesarean delivery', Obstetrics and Gynecology, vol. 114, no. 4, pp. 752-756. https://doi.org/10.1097/AOG.0b013e3181b8f28f
Dinsmoor MJ, Gilbert S, Landon MB, Rouse DJ, Spong CY, Varner MW et al. Perioperative antibiotic prophylaxis for nonlaboring cesarean delivery. Obstetrics and Gynecology. 2009 Oct 1;114(4):752-756. https://doi.org/10.1097/AOG.0b013e3181b8f28f
Dinsmoor, Mara J. ; Gilbert, Sharon ; Landon, Mark B. ; Rouse, Dwight J. ; Spong, Catherine Y. ; Varner, Michael W. ; Caritis, Steve N. ; Wapner, Ronald J. ; Sorokin, Yoram ; Miodovnik, Menachem ; O'Sullivan, Mary J. ; Sibai, Baha M. ; Langer, Oded. / Perioperative antibiotic prophylaxis for nonlaboring cesarean delivery. In: Obstetrics and Gynecology. 2009 ; Vol. 114, No. 4. pp. 752-756.
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AU - Gilbert, Sharon

AU - Landon, Mark B.

AU - Rouse, Dwight J.

AU - Spong, Catherine Y.

AU - Varner, Michael W.

AU - Caritis, Steve N.

AU - Wapner, Ronald J.

AU - Sorokin, Yoram

AU - Miodovnik, Menachem

AU - O'Sullivan, Mary J.

AU - Sibai, Baha M.

AU - Langer, Oded

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N2 - OBJECTIVE: To estimate the efficacy of antibiotic prophylaxis at the time of nonlaboring cesarean delivery in reducing postpartum infection-related complications. METHODS: We performed a secondary analysis of an observational study of cesarean deliveries performed at 13 centers from 1999-2000. Patients were included if they had cesarean delivery before labor, did not have intrapartum infection, and were not given antibiotics at delivery for reasons other than prophylaxis. The occurrence of postpartum endometritis, wound infection, and other, less common infection-related complications was compared between those who did and did not receive antibiotic prophylaxis. Results were adjusted for smoking, payer status, gestational age and body mass index at delivery, race, diabetes, antepartum infections, presence of anemia, operative time, type of cesarean delivery (primary or repeat), and center. RESULTS: Of the 9,432 women who met study criteria, the 6,006 (64%) who received antibiotic prophylaxis were younger, heavier at delivery, and were more likely to be African American, receive public insurance, and have diabetes. Patients who received antibiotic prophylaxis were less likely to develop postpartum endometritis (121 [2.0%] compared with 88 [2.6%], adjusted odds ratio [OR] 0.40, 95% confidence interval [CI] 0.28-0.59) or wound infection (31 [0.52%] compared with 33 [0.96%], adjusted OR 0.49, 95% CI 0.28-0.86). CONCLUSION: Antibiotic prophylaxis at the time of nonlaboring cesarean delivery significantly reduces the risks of postpartum endometritis and wound infection.

AB - OBJECTIVE: To estimate the efficacy of antibiotic prophylaxis at the time of nonlaboring cesarean delivery in reducing postpartum infection-related complications. METHODS: We performed a secondary analysis of an observational study of cesarean deliveries performed at 13 centers from 1999-2000. Patients were included if they had cesarean delivery before labor, did not have intrapartum infection, and were not given antibiotics at delivery for reasons other than prophylaxis. The occurrence of postpartum endometritis, wound infection, and other, less common infection-related complications was compared between those who did and did not receive antibiotic prophylaxis. Results were adjusted for smoking, payer status, gestational age and body mass index at delivery, race, diabetes, antepartum infections, presence of anemia, operative time, type of cesarean delivery (primary or repeat), and center. RESULTS: Of the 9,432 women who met study criteria, the 6,006 (64%) who received antibiotic prophylaxis were younger, heavier at delivery, and were more likely to be African American, receive public insurance, and have diabetes. Patients who received antibiotic prophylaxis were less likely to develop postpartum endometritis (121 [2.0%] compared with 88 [2.6%], adjusted odds ratio [OR] 0.40, 95% confidence interval [CI] 0.28-0.59) or wound infection (31 [0.52%] compared with 33 [0.96%], adjusted OR 0.49, 95% CI 0.28-0.86). CONCLUSION: Antibiotic prophylaxis at the time of nonlaboring cesarean delivery significantly reduces the risks of postpartum endometritis and wound infection.

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