Surgical Wound Complications and Incision Site Infection in Caesarean Section versus Vaginal Delivery: A Meta-Analysis

Thuraya Aljibali; Hajer Elkout

doi:10.54361/ajmas.269805

Authors

Thuraya Aljibali Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Tripoli, Tripoli, Libya https://orcid.org/0000-0003-2092-0915
Hajer Elkout Department of Family and Community Medicine, Faculty of Medicine - University of Tripoli, Tripoli, Libya https://orcid.org/0000-0003-3191-3868

DOI:

https://doi.org/10.54361/ajmas.269805

Keywords:

Caesarean Section, Vaginal Delivery, Surgical Site Infection, Wound Complications, Meta-Analysis

Abstract

Caesarean section (CS) accounts for over 20% of global deliveries, yet rigorous estimates comparing surgical site infection (SSI) risks between delivery modes remain limited. The study aims to synthesize global comparative evidence on SSI incidence and effect size and wound complications across eligible studies. Following PRISMA 2020 guidelines, eight databases (including regional and Arabic-language sources) were searched (2014–2026) for studies comparing post-delivery SSI rates with ≥30 days follow-up. Risk estimates were pooled using random-effects meta-analysis. Analysis of 63 studies (N = 1,247,819 deliveries) showed CS was associated with significantly higher SSI odds than vaginal delivery (pooled OR = 4.87, 95% CI: 3.94–6.02). Wound dehiscence risk was elevated sixfold (OR = 6.31, 95% CI: 4.88–8.17). CS carries a significant, neglected surgical infection burden. Implementing targeted standardised prevention protocols, optimised prophylaxis, structured post-discharge surveillance, and regional quality assurance monitoring are essential to mitigate postoperative maternal morbidity.