Risk of cesarean wound complications in diabetic gestations

Am J Obstet Gynecol. 2004 Sep;191(3):958-63. doi: 10.1016/j.ajog.2004.05.063.


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/m 2 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • Cesarean Section / adverse effects*
  • Cohort Studies
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / epidemiology
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / epidemiology
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Logistic Models
  • Odds Ratio
  • Postoperative Complications*
  • Pregnancy
  • Pregnancy in Diabetics / complications*
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Dehiscence / epidemiology
  • Surgical Wound Infection / epidemiology