Having a baby by Caesarean section is becoming increasingly common, despite the higher risks associated with the surgery compared to a vaginal birth. One important concern is the risk of infection, which is between five and 20 times greater for women who undergo scheduled or emergency Caesarean section.
In fact, "the single most important risk factor for postpartum maternal infection is Caesarean section," according to a new Cochrane review. The researchers looked at 86 studies involving more than 13,000 women to determine whether the use of antibiotics to prevent infection was beneficial.
According to review findings, giving prophylactic — or preventive — antibiotics to women undergoing Caesarean section reduced the incidence of fever by 45 percent, wound infection by 39 percent, inflammation of the uterine lining by 38 percent and serious infectious complications for the mother by 31 percent.
"The most salient points [of the review] are that antibiotic prophylaxis is effective in preventing infectious complications post-Caesarean section, whether elective or emergency," said lead review author Fiona Smaill, M.D, at McMaster University in Ontario, Canada
Smaill said the review did not consider specific types of antibiotics or length of treatment.
"Unfortunately this study does not tell us what impact the use of antibiotics, particularly if given before delivery, has on the infant," said Christian Pettker, an assistant professor in obstetrics, gynecology and reproductive sciences at Yale University. Very few studies in the review looked at infant outcomes. For example, none of the studies looked at infant oral thrush, an infection of the mouth seen in newborn infants or in infants on antibiotic treatment. There were no adverse effects seen in the few studies that did address the issue.
"The absence of infant outcomes," Smaill said, "makes it difficult for women to assess the benefits versus risks. While overall any risk to the infant is likely to be minor, many women are concerned about any antibiotic exposure."
The new review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence based conclusions about medical practice after considering both the content and quality of existing trials on a topic.