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Poster Session 3

Category: Health Equity/Community Health

Poster Session 3

(748) Effect of health care access on post-cesarean surgical site infection severity (SSI)

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author(s)

Hannah Kelly, MD

OB/GYN Resident
Duke University Hospital
Durham, North Carolina, United States

Coauthor(s)

Carmen Rauh Garrido, MD, MS

Resident physician
Stanford University Department of Obstetrics & Gynecology
Stanford University, California, United States

Presenting Author(s)

Emma Peek, BS

Medical student
Duke University School of Medicine
Duke University Medical Center, North Carolina, United States

Coauthor(s)

KC

Kathleen Chang, BS

Duke University School of Medicine
Durham, North Carolina, United States
JL

Joyce Liu, BS

Duke University School of Medicine
Durham, North Carolina, United States
JW

Janice Wong, MD

Fellow
UCSD Department of Obstetrics and Gynecology
UCSD, California, United States
SD

Sarah K. Dotters-Katz, MD

Associate Professor of Obstetrics and Gynecology
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University
Duke University/Durham, North Carolina, United States
Rachel L. Wood, MD (she/her/hers)

Assistant Professor of Obstetrics and Gynecology
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University
Durham, North Carolina, United States

Objective:
Patients who have increased access to health care have been shown to have better health outcomes. Patients from marginalized communities in particular face healthcare access barriers compounding pre-existing disparities. Our study sought to assess how healthcare access affects post-cesarean surgical site infection (SSI).

Study Design:
This was an IRB-approved, retrospective cohort study of patients with post-cesarean wound infections requiring an emergency department or OB-ED wound-related visit from a single health-care system between 6/1/2013-7/31/2022, excluding patients with placenta accreta or severe preeclampsia. Primary exposure was appropriate access to postpartum care “touchpoints”, defined as having attended a postpartum appointment, called nurse line, or EHR messaged which led to an appointment prior to diagnosis of SSI. The outcomes of interest were the location of SSI diagnosis, severity of wound infection based upon the need for hospital admission or surgical intervention. Bivariate statistics were used to analyze data. Regression models were developed to control confounders.

Results:
528 patients were included in this analysis, 390 (73.9%) had accessed healthcare before their SSI diagnosis (“prior touchpoint” group) and 141 (26.7%) whose first postpartum healthcare access was at the time of SSI diagnosis (“no prior touchpoint” group). Patients with no prior touchpoint were younger and more likely to be Black with public insurance (Table 1). Patients with no prior touchpoint had an increased odds of being diagnosed in an emergency setting (4.3, 95% CI 2.8-6.5), requiring readmission for SSI (OR 1.9, 95% CI 1.3-3.0) and requiring return to the OR for surgical intervention (OR 1.9, 95% CI 1.1- 3.2). Both emergency setting and readmission remained significant only after adjusting for confounders (maternal age, BMI, and insurance status) (Table 2).

Conclusion:
Patients who accessed less medical care before SSI diagnosis were more likely to require readmission again highlighting the disparity faced by individuals lacking healthcare access.