What is the most important risk factor for infection in the postpartum period?

Cesarean delivery is considered the most important risk factor for infection in the postpartum period due to several reasons related to the surgical nature of the procedure.

During a cesarean section, the skin and deeper tissue layers are incised, providing an entry point for pathogens that can lead to surgical site infections (SSI). Additionally, cesarean deliveries often involve longer operative times and increased exposure of the surgical site, factors that contribute to a higher incidence of infection compared to vaginal deliveries, which typically do not involve such extensive tissue disruption.

Moreover, the disruption of normal flora and the potential for foreign material, such as sutures or mesh, to provide a surface for bacterial colonization further escalate the risk of developing infections post-cesarean. The presence of any additional complications, such as obesity, diabetes, or chorioamnionitis, which are more prevalent in women undergoing cesarean delivery, can compound this risk.

In contrast, while vaginal delivery, prolonged labor, and general anesthesia may also be associated with certain risks, they do not have the same direct and substantial impact on increasing the likelihood of infection as cesarean delivery does. Vaginal deliveries are less invasive, and the associated risk of infection tends to be significantly lower, especially