Postoperative Antimicrobial Prophylaxis After Cesarean Delivery With Obesity

Cesarean delivery is one of the most commonly performed surgical procedures. In 2015, 1.27 million infants born in the United States, representing 32% of all US births, were born by cesarean delivery. Cesarean delivery is the most important risk factor for infection in the postpartum period. Surveillance for postcesarean surgical site infection (SSI) conducted in the United States between 2006 and 2008 demonstrated an overall SSI rate of approximately 2%, but infection rates of up to 20% have been observed in some clinical studies. Several factors have been associated with the development of postcesarean SSI, including emergency surgery, onset of labor prior to delivery, membrane rupture prior to surgery, surgical wound class, procedure duration, and obesity. Among these, obesity is one of the most commonly encountered risk factors. In 2014, 24.8% of women who gave birth in the United States were obese (body mass index >29.9). Thus, an estimated 315 000 infants are born to obese women by cesarean delivery in the United States each year.