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/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. (C) 2004 Elsevier Inc. All rights reserved.