Background and Aims: Hyperglycemia has been identified as a risk factor for infection after operation. However, the association between maternal peri-operative glucose level and post-cesarean section infection has yet to be elucidated. We used CGM to profile maternal peri-operative glucose characteristics and determine the effect on post-cesarean section infection.
Materials and Methods: This is a prospective, observational cohort study with 227 pregnant women who wore CGM before cesarean section during 2020-2022 in China. The primary outcome was maternal infection within 6 weeks after cesarean section. The definition of maternal infection was one or more than one of the following: surgical site infection (SSI), endometritis, urinary tract infection, and febrile morbidity. Logistic regression models were used to evaluate the association between CGM metrics and maternal infection with estimated risk ratios (RRs) and 95% CIs.
Results: Of the 227 studied women, 110 (48.25%) were categorized into the hyperglycemia in pregnancy (HIP) group, and 118 (51.75%) were in the non-HIP group. The incidence of post-cesarean section infection was significantly higher in the HIP group (17.43%) compared with the non-HIP group (7.63%, RR2.46, 95%CI(1.307-4.651)). Women who had post-operative infection had a significantly higher level of 3 post-operation-days(PODS) mean glucose (5.20 vs. 4.79, adjusted RR 1.03,P=0.017), glucose management indicator (5.54 vs. 5.37, adjusted RR 1.29,95% CI(1.22-10.85)), estimated HbA1c (4.89 vs. 4.63, adjusted RR 1.93,P=0.016), TAR10.0 (3.68 vs. 1.84, adjusted RR 1.17, 95% CI(1.01-1.39)), and TAR7.0 (15.68 vs. 9.98, adjusted RR 1.04, 95% CI(1.00-1.09)).
Conclusion: Women with HIP had higher incidence of post-cesarean section infection. Post-operative glucose hyperglycemia, estimated by CGM metrics, was significantly associated with post-cesarean section infection.
Y. Liu: None. Y. Ding: None. Y. Gong: None. T. Wei: None. S. Chen: None. X. Zheng: None. S. Luo: None. J. Weng: None.
