Risk factors for wound complications in morbidly obese women undergoing primary cesarean delivery

J Matern Fetal Neonatal Med. 2012 Sep;25(9):1544-8. doi: 10.3109/14767058.2011.653422. Epub 2012 Feb 13.


Objective: To determine factors influencing separation and infectious type wound complications (WCs) in morbidly obese women undergoing primary cesarean delivery (CD).

Methods: Retrospective cohort study evaluating infectious and separation WC in morbidly obese (body mass index [BMI] > 35 kg/m(2)) women undergoing primary CD between January 1994 and December 2008. Chi-square, Fisher's exact and Student's t tests used to assess associated factors; backward logistic regression to determine unadjusted and adjusted odds ratios.

Results: Of 623 women, low transverse skin incisions were performed in 588 (94.4%), vertical in 35 (7%). Overall WC rate was 13.5%, which varied by incision type (vertical 45.7% vs. 11.6% transverse; p < 0.01), but not BMI class. Incision type and unscheduled CD were associated with infection risk, while incision type, BMI, race and drain use were associated with wound separation.

Conclusion: In morbidly obese women both infectious and separation type WC are more common in vertical than low transverse incisions; therefore transverse should be preferred.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Cesarean Section / rehabilitation
  • Cesarean Section / statistics & numerical data
  • Cohort Studies
  • Female
  • Humans
  • Infant, Newborn
  • Obesity, Morbid / complications
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Parity
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / surgery*
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Dehiscence / epidemiology
  • Surgical Wound Dehiscence / etiology
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology
  • Young Adult