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CME Credit Offered
CME Credit Offered
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Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
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AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Obstetric Quality and Safety

Poster Session 4

(1136) Cesarean SSI and BMI: Relationship between the Two in the Era of Modern Antibiotic Prevention

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Objective:
Updated antibiotic regimens and prevention bundles have reduced surgical site infection (SSI) rates after cesarean delivery (CD), but SSI remains a concern. Elevated BMI has traditionally been a major risk factor, yet its impact amid evolving clinical protocols is uncertain. We sought to evaluate the association between BMI and SSI following CD in the context of modern perioperative practices.

Study Design:
We performed a case control of all CDs at an urban tertiary care center from January 2024-July 2025 where antibiotic dosage by BMI, azithromycin for labored CD, and redosing for extended operative time and high blood loss are standard practice. Cases were defined as patients with SSI based on National Healthcare Safety Network criteria, without exclusions for BMI >60; controls were CDs without SSI during the same period. The primary exposure was BMI. Multivariable logistic regression estimated adjusted odds ratios (aORs) for SSI. Covariates included age, quantitative blood loss, repeat CD, and other clinical factors. Stratified analyses compared scheduled versus labored CDs (after labor onset or rupture of membranes).

Results:
We identified 32 CD with SSI and 1,761 without. In unadjusted analysis, BMI 35–45 kg/m² was significantly associated with higher odds of SSI (OR 2.70, 95% CI 1.07–8.22; Figure, Table). However, after multivariable adjustment with backwards selection, BMI was no longer significantly associated with SSI. Only maternal age remained in the final model, with each additional year linked to a 9.2% reduction in odds of SSI (aOR 0.91, 95% CI 0.83–0.99). In stratified analyses, BMI was not significantly associated with SSI in either scheduled or labored CD. However, younger maternal age remained significantly associated with increased SSI risk in the labored group.

Conclusion:
In the era of updated antibiotic regimens and bundled care, BMI did not independently predict SSI risk following CD after adjusting for other factors. Younger maternal age emerged as a key risk factor, possibly reflecting social determinants affecting SSI risk.