Magnitude and Associated Factors of Surgical Site Infection Following Cesarean Section: A Cross-Sectional Study in Southern Ethiopia.

BACKGROUND AND AIM: Surgical site infections (SSIs) occur at the incision site or in deeper tissues within 30 days of surgery and represent a significant public health concern, contributing substantially to maternal morbidity and mortality. Evidence on the magnitude and associated factors of SSIs among women undergoing cesarean delivery in this setting remains limited, and several potentially influential variables have not yet been explored. Therefore this study aimed to determine the prevalence and associated factors of post-cesarean section surgical site infection in Southern Ethiopia.

METHODS

An institution-based cross-sectional study was conducted among mothers who underwent cesarean section at WSUCSH from March 1 to September 1, 2024. Surgical site infection (SSI) was defined as an infection developing at the cesarean delivery operative site within 30 days of surgery, diagnosed by the attending clinician. A systematic random sampling technique was used to select 275 patient records from all cesarean delivery cases during the study period. Data were entered into Epi-Data and analyzed using SPSS version 25. Binary logistic regression was performed to identify factors associated with the outcome variable. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated to measure the strength of associations, with statistical significance set at p < 0.05.

RESULTS

The overall post-cesarean SSI rate was 8.8% (95% CI: 5.0-12.0). Prolonged operative duration (AOR = 3.27, 95% CI: 1.11-9.61), prolonged rupture of membranes prior to surgery (AOR = 3.53, 95% CI: 1.23-10.14), presence of chorioamnionitis (AOR = 4.36, 95% CI: 1.06-17.86), inadequate vaginal antiseptic preparation (AOR = 4.32, 95% CI: 1.13-16.48), excessive intraoperative blood loss (AOR = 3.73, 95% CI: 1.34-10.39), and a postoperative hematocrit below 30% (AOR = 4.34, 95% CI: 1.47-12.85) were identified as independent risk factors for SSI.

CONCLUSIONS

Post-cesarean SSI remains a notable concern in this setting. Minimizing operative time, ensuring adequate vaginal antiseptic preparation, promptly managing prolonged membrane rupture, early treatment of intra-partum infections, and correction of maternal anemia are critical strategies for reducing post-cesarean SSI.