Trial reportObstetrics and gynecology2017
Risk Factors for Postcesarean Maternal Infection in a Trial of Extended-Spectrum Antibiotic Prophylaxis.
Trial report in Obstetrics and gynecology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03960970 (Azithromycin-based Extended-spectrum Prophylaxis in Scheduled Cesarean Deliveries), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Azithromycin-based Extended-spectrum Prophylaxis in Scheduled Cesarean Deliveries
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Adverse events in people taking macrolide antibiotics versus placebo for any indication.The Cochrane database of systematic reviews · 2019Pooled it
- Vaginal cleansing before unscheduled cesarean delivery to reduce infection: a randomized clinical trial.American journal of obstetrics and gynecology · 2023Trial
- Timing of Adjunctive Azithromycin for Unscheduled Cesarean Delivery and Postdelivery Infection.Obstetrics and gynecology · 2022Trial
- Nurse Perceptions of Barriers to Infection Prevention and Control in Labor and Delivery.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2025Article
- Nomogram for predicting the risk of nosocomial infections among obstetric inpatients: a large-scale retrospective study in China.BMC infectious diseases · 2024Observational
- The awareness of enhanced recovery after surgery (ERAS) cesarean delivery guidelines among anesthesiology and reanimation assistants in Turkey; a questionnaire study.BMC anesthesiology · 2024Article
- Endometritis - Diagnosis,Treatment and its impact on fertility - A Scoping Review.JBRA assisted reproduction · 2022Article
- DocumentedInfectious diseases in obstetrics and gynecology · 2022Article
- The association between preeclampsia and ICD diagnosis of neonatal sepsis.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Reducing Cesarean Delivery Surgical Site Infections: A Resident-Driven Quality Initiative.Obstetrics and gynecology · 2019Article
- Risk factors for surgical site infection following cesarean delivery: a retrospective cohort study.CMAJ open · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
objectiveTo identify maternal clinical risk factors for postcesarean maternal infection in a randomized clinical trial of preincision extended-spectrum antibiotic prophylaxis.
methodsWe conducted a planned secondary analysis of a randomized clinical trial. Patients were 24 weeks of gestation or greater and delivered by cesarean after a minimum of 4 hours of ruptured membranes or labor. All participants received standard preincision prophylaxis and were randomized to receive azithromycin or placebo. The primary outcome for this analysis is maternal infection: a composite outcome of endometritis, wound infection (superficial or deep), or other infections occurring up to 6 weeks postpartum. Maternal clinical characteristics associated with maternal infection, after controlling for azithromycin assignment, were identified. These maternal factors were included in a multivariable logistic regression model for maternal infection.
resultsOf 2,013 patients, 1,019 were randomized to azithromycin. Overall, 177 (8.8%) had postcesarean maternal infection. In the final adjusted model, compared with the reference groups, women of black race-ethnicity, with a nontransverse uterine incision, with duration of membrane rupture greater than 6 hours, and surgery duration greater than 49 minutes, were associated higher odds of maternal infection (all with adjusted odds ratios [ORs] of approximately 2); azithromycin was associated with lower odds of maternal infection (adjusted OR 0.4, 95% confidence interval 0.3-0.6).
conclusionDespite preincision azithromycin-based extended-spectrum antibiotic prophylaxis, postcesarean maternal infection remains a significant source of morbidity. Recognition of risk factors may help guide innovative prevention strategies. CLINICAL
trial registrationClinicalTrials.gov, https://clinicaltrials.gov, NCT012235546.
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