Association of Treatment of Chorioamnionitis with Non-Beta Lactam Antibiotics and Postcesarean Infectious Morbidity.

OBJECTIVE: Chorioamnionitis (CAM) is associated with postcesarean (CS) infectious morbidity (IM). Beta-lactam antibiotics (BLA) are used to treat CAM. It is uncertain if women who cannot receive BLA attain similar benefit from treatment of CAM with non-BLA. STUDY DESIGN: Retrospective cohort of women with CAM is delivered by CS in the maternal-fetal medicine units CS registry. We compared IM in women who received BLA versus women who received non-BLA. The primary outcome was a composite of endometritis, wound complication, necrotizing fasciitis, septic pelvic thrombophlebitis, and pelvic abscess. Multivariable logistic regression estimated odds ratios for the association of non-BLA treatment with IM outcomes. RESULTS: A total of 3,063 (93%) women received BLA, and 232 (7%) received non-BLA. Groups had similar rates of composite post-CS IM (10.6 vs. 12.1%, p = 0.5). After adjusting for confounders, treatment of CAM with non-BLA was not associated with post-CS IM (adjusted odds ratio [AOR] 1.1, 95% confidence interval [CI] 0.6-1.7), endometritis (AOR 1.1, 95% CI 0.7-1.8), or wound complications (AOR 1.2, 95% CI 0.5-3.2). CONCLUSION: Women with CAM who receive non-BLA and require CS may not be at increased risk of postoperative infections complications, compared to women who receive BLA.

Duke Scholars

Author Sarah K. Dotters-Katz Obstetrics and Gynecology, Maternal Fetal Medicine