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Alcohol Use Disorders and Hospital-Acquired Infections in Women Undergoing Cesarean Delivery

de Wit, Marjolein MD, MSc; Goldberg, Aaron MD; Chelmow, David MD

doi: 10.1097/AOG.0b013e318297be8d
Original Research

OBJECTIVE: To determine the risk of hospital-acquired infection in women with alcohol use disorders undergoing cesarean delivery.

METHODS: Using the Nationwide Inpatient Sample, we conducted a retrospective cohort study of women undergoing cesarean delivery from 2002 to 2010. Women with a diagnosis of alcohol use disorder were compared with women without alcohol use disorders. Hospital-acquired infections include surgical site infection, endometritis, urinary tract infection, sepsis, and pneumonia.

RESULTS: A total of 12,081 women with alcohol use disorders were identified and matched with 11,960 women without alcohol use disorders. Women with alcohol use disorders were more likely to have development of urinary tract infection and sepsis. By multivariable analyses, women with alcohol use disorders had higher odds of hospital-acquired infections (odds ratio 2.2, 95% confidence interval [CI] 1.9–2.7; P=2×10−19; 397 among those with alcohol use disorders and 179 among those without alcohol use disorders; number needed to harm 55). Length of stay was longer in women with alcohol use disorders, but this was unexplained by hospital-acquired infection (3.3 days; 95% CI 3.2–3.3 compared with 3.1 days; 95% CI 3.0–3.1; P=4×10−7).

CONCLUSION: Women with alcohol use disorders undergoing cesarean delivery have increased risk of hospital-acquired infections. Interventions aimed at decreasing alcohol use disorders during pregnancy may reduce maternal and fetal complications.

LEVEL OF EVIDENCE: II

Women with alcohol use disorders undergoing cesarean delivery have increased risk of hospital-acquired infections.

Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, and the Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia.

Corresponding author: Aaron Goldberg, MD, Department of Obstetrics and Gynecology, Virginia Commonwealth University, 1200 East Broad Street, Main Hospital, 8th Floor, Richmond, VA 23298; e-mail: agoldberg@mcvh-vcu.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2013 by The American College of Obstetricians and Gynecologists.