Giving antibiotics before cesarean section surgery rather than just after the newborn's umbilical cord is clamped cuts the infection rate at the surgical site in half, according to researchers at Washington University School of Medicine in St. Louis and Barnes-Jewish Hospital.
"We followed more than 8,000 women over an eight-year period, and our findings support giving antibiotics just before a cesarean section to prevent infections," says infectious disease specialist David K. Warren, MD. "Until recently, standard practice in the U.S. was to give antibiotics when the baby was delivered, after the umbilical cord was clamped."
The study is available online and appears in the August issue of Obstetrics & Gynecology.
The previous practice of waiting to give antibiotics until after the surgical delivery of the baby evolved out of concern that these drugs might hide signs of blood infection in the newborn. But other recent studies have shown that giving antibiotics in the hour before surgery both reduced the risk of infection in the mother and had no effect on the health of the infant.
"It was always a theoretical concern that giving antibiotics might somehow mask sepsis in the neonate," says Warren, associate professor of medicine. "But there have been several recent studies showing that this was not an issue."
In this study, the researchers tracked C-section deliveries and associated surgical site infections at Barnes-Jewish Hospital between January 2003-December 2010. Based on reduced infection rates following other types of surgeries, the hospital changed its policy to administering antibiotics before C-section surgery in January 2004. The American College of Obstetricians and Gynecologists recommended the same change in practice in 2011.