High incidence of surgical site infections after caesarean deliveries in cameroonian referral hospitals: A Prospective Cohort Study

Abstract

Background: Cesarean section, as a surgical procedure, exposes patients to a specific risk of surgical site infection (SSI), which is a major cause of postpartum maternal morbidity. This study aimed to estimate the incidence of post-cesarean SSIs and identify associated risk factors in two referral hospitals in Douala, Cameroon.

Methods: Between February and July 2022, 444 women who underwent cesarean section at Laquintinie Hospital and the Douala Gyneco-Obstetric and Pediatric Hospital were included in a prospective cohort study. Clinical, obstetric, and perioperative data were collected using a standardized questionnaire. Cases of SSI (n = 45) were monitored. Multivariate logistic regression was used to identify factors associated with SSIs (p < 0.05).

Results: The overall incidence of SSIs was 10.13%, higher at Laquintinie Hospital (11.11%) than at the Gyneco-Obstetric Hospital (6.45%). Independent risk factors identified included: obesity (Adjusted OR = 5.9; p = 0.032), preoperative anemia (Adjusted OR = 4.7; p = 0.030), diabetes (Adjusted OR = 15.7; p = 0.013). Perioperative blood transfusion was significantly associated with a reduction in risk (Adjusted OR = 0.05; p = 0.013).

Conclusion: Post-cesarean SSIs are common in referral hospitals in Douala. Managing metabolic comorbidities (obesity, diabetes) and hematologic conditions (anemia), as well as optimizing perioperative care, could help reduce this burden.