OBJECTIVES

: Cesarean section (CS) is a common procedure and accounts for more than 30% of all deliveries in the United States. Postpartum SSI has been reported at rates between 2% to 7%. This study was designed to accurately assess rates of SSI following CS in a large database and identify associated clinical and social risk factors.

METHODS

: Patients who had a CS between 2014 and 2017 were identified in MarketScan Commercial and Medicaid administrative claims databases. All patients were categorized by demographic and clinical co-morbidities using the 31 domains of the Elixhauser Comorbidity Index. Additional factors included smoking, site of admission (i.e., emergency vs inpatient vs outpatient admissions) and payer type. SSIs were identified from 1 to 180 days post-operative using diagnostic codes of superficial or deep incisional SSI. Logistic regression models were developed to evaluate associated variables. Generalized linear regression models were built and adjusted total payments in US$ with or without SSI were estimated using least squares means with assessment of the difference in all-cause costs up to 6 months post-operative.

RESULTS

: CONCLUSIONS

: Infection following Cesarean section may be associated with many clinical and social/behavioral factors, and can result in significant costs.