Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis

BackgroundSurgical site infections (SSIs) are the most common postoperative complications after cesarean section (CS), with increased mortality, prolonged hospital stays, and increased healthcare costs. ObjectiveTo systematically estimate the global incidence and identify the risk factors associated...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Nazmul, Islam (author)
مؤلفون آخرون: Thalib, Lukman (author), Mahmood, Sadia (author), Varol, Sameed Akif (author), Adel, Ibrahim (author), Aqel, Abdelrahman (author), Atashbari, Fatemeh (author), Cinar, Ozer (author)
التنسيق: article
منشور في: 2025
الموضوعات:
الوصول للمادة أونلاين:http://dx.doi.org/10.1016/j.iccn.2025.103951
https://www.sciencedirect.com/science/article/pii/S0964339725000126
http://hdl.handle.net/10576/64039
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author Nazmul, Islam
author2 Thalib, Lukman
Mahmood, Sadia
Varol, Sameed Akif
Adel, Ibrahim
Aqel, Abdelrahman
Atashbari, Fatemeh
Cinar, Ozer
author2_role author
author
author
author
author
author
author
author_facet Nazmul, Islam
Thalib, Lukman
Mahmood, Sadia
Varol, Sameed Akif
Adel, Ibrahim
Aqel, Abdelrahman
Atashbari, Fatemeh
Cinar, Ozer
author_role author
dc.creator.none.fl_str_mv Nazmul, Islam
Thalib, Lukman
Mahmood, Sadia
Varol, Sameed Akif
Adel, Ibrahim
Aqel, Abdelrahman
Atashbari, Fatemeh
Cinar, Ozer
dc.date.none.fl_str_mv 2025-03-30T07:08:57Z
2025-01-28
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://dx.doi.org/10.1016/j.iccn.2025.103951
Islam, N., Thalib, L., Mahmood, S., Varol, S. A., Adel, I., Aqel, A., ... & Cinar, O. (2025). Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis. Intensive and Critical Care Nursing, 89, 103951.
0964-3397
https://www.sciencedirect.com/science/article/pii/S0964339725000126
http://hdl.handle.net/10576/64039
89
1532-4036
dc.language.none.fl_str_mv en
dc.publisher.none.fl_str_mv Elsevier
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Surgical site infection
Cesarean section
Incidence
Risk factors
Systematic review
Meta-analysis
dc.title.none.fl_str_mv Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description BackgroundSurgical site infections (SSIs) are the most common postoperative complications after cesarean section (CS), with increased mortality, prolonged hospital stays, and increased healthcare costs. ObjectiveTo systematically estimate the global incidence and identify the risk factors associated with SSI, focusing on the variation between high- and low-income countries. Search strategy and selection criteriaObservational studies reporting on the incidence of SSI after CS were systematically searched in PubMed, Embase and SCOPUS. Data collection and analysisMultiple authors independently screened, extracted the data, and assessed therisk of bias. The primary outcome was the incidence of SSI within 30 days. Subgroup and sensitivity analyses and meta-regression examined SSI-related heterogeneity. Main results49 cohort studies with 271,954 participants met the inclusion criteria. We found with moderate certainty that the overall SSI incidence in CS patients was 7.0 % (95 % CI: 6.0 %–8.0 %). The SSI incidence in LMICs was 8.0 % (95 % CI: 6.0 %–10.0 %) with moderate certainty, while the incidence in HICs was 5.0 % (95 % CI: 4.0 %–7.0 %) with low certainty. Subgroup analysis indicated a significantly higher incidence in Africa and the Western Pacific. Meta-regression showed a significant decrease in SSI incidence in HICs. Maternal factors, procedural aspects, and care quality were associated with SSI. ConclusionsOur findings offer valuable insights into the global incidence of SSIs following CS and provide a reliable estimate for benchmarking and quality improvement. This study adds to the evidence on SSI determinants and highlights the need for targeted preventative measures across various regional and healthcare settings. Implications for clinical practiceHigher SSI rates in LMICs call for targeted infection prevention strategies, including improved preoperative preparation, antibiotic prophylaxis, and enhanced antenatal care services. In HICs, addressing lifestyle factors, managing comorbidities, and refining surgical protocols can further mitigate risks, emphasizing the need for region-specific, evidence-based interventions.
eu_rights_str_mv openAccess
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identifier_str_mv Islam, N., Thalib, L., Mahmood, S., Varol, S. A., Adel, I., Aqel, A., ... & Cinar, O. (2025). Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis. Intensive and Critical Care Nursing, 89, 103951.
0964-3397
89
1532-4036
language_invalid_str_mv en
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spelling Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-AnalysisNazmul, IslamThalib, LukmanMahmood, SadiaVarol, Sameed AkifAdel, IbrahimAqel, AbdelrahmanAtashbari, FatemehCinar, OzerSurgical site infectionCesarean sectionIncidenceRisk factorsSystematic reviewMeta-analysisBackgroundSurgical site infections (SSIs) are the most common postoperative complications after cesarean section (CS), with increased mortality, prolonged hospital stays, and increased healthcare costs. ObjectiveTo systematically estimate the global incidence and identify the risk factors associated with SSI, focusing on the variation between high- and low-income countries. Search strategy and selection criteriaObservational studies reporting on the incidence of SSI after CS were systematically searched in PubMed, Embase and SCOPUS. Data collection and analysisMultiple authors independently screened, extracted the data, and assessed therisk of bias. The primary outcome was the incidence of SSI within 30 days. Subgroup and sensitivity analyses and meta-regression examined SSI-related heterogeneity. Main results49 cohort studies with 271,954 participants met the inclusion criteria. We found with moderate certainty that the overall SSI incidence in CS patients was 7.0 % (95 % CI: 6.0 %–8.0 %). The SSI incidence in LMICs was 8.0 % (95 % CI: 6.0 %–10.0 %) with moderate certainty, while the incidence in HICs was 5.0 % (95 % CI: 4.0 %–7.0 %) with low certainty. Subgroup analysis indicated a significantly higher incidence in Africa and the Western Pacific. Meta-regression showed a significant decrease in SSI incidence in HICs. Maternal factors, procedural aspects, and care quality were associated with SSI. ConclusionsOur findings offer valuable insights into the global incidence of SSIs following CS and provide a reliable estimate for benchmarking and quality improvement. This study adds to the evidence on SSI determinants and highlights the need for targeted preventative measures across various regional and healthcare settings. Implications for clinical practiceHigher SSI rates in LMICs call for targeted infection prevention strategies, including improved preoperative preparation, antibiotic prophylaxis, and enhanced antenatal care services. In HICs, addressing lifestyle factors, managing comorbidities, and refining surgical protocols can further mitigate risks, emphasizing the need for region-specific, evidence-based interventions.Elsevier2025-03-30T07:08:57Z2025-01-28Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1016/j.iccn.2025.103951Islam, N., Thalib, L., Mahmood, S., Varol, S. A., Adel, I., Aqel, A., ... & Cinar, O. (2025). Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis. Intensive and Critical Care Nursing, 89, 103951.0964-3397https://www.sciencedirect.com/science/article/pii/S0964339725000126http://hdl.handle.net/10576/64039891532-4036enhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/640392025-03-30T19:05:48Z
spellingShingle Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis
Nazmul, Islam
Surgical site infection
Cesarean section
Incidence
Risk factors
Systematic review
Meta-analysis
status_str publishedVersion
title Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis
title_full Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis
title_fullStr Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis
title_full_unstemmed Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis
title_short Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis
title_sort Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and Meta-Analysis
topic Surgical site infection
Cesarean section
Incidence
Risk factors
Systematic review
Meta-analysis
url http://dx.doi.org/10.1016/j.iccn.2025.103951
https://www.sciencedirect.com/science/article/pii/S0964339725000126
http://hdl.handle.net/10576/64039