A Perioperative Quality Improvement Program for Cesarean Delivery in Ethiopia: A Stepped-Wedge Cluster Randomized Clinical Trial
Primary result · Surgical site infectionResult — go to the resultOdds ratio 0.84 95% CI 0.55–1.27Authors' conclusion
In this stepped-wedge cluster randomized clinical trial of patients undergoing cesarean delivery, no significant reductions in surgical site infections were observed. However, compliance with perioperative standards improved following the intervention.
Study context
- Population
- Women undergoing cesarean delivery at 9 hospitals in 5 clusters in Ethiopia, Aug 2021–Jan 20235,153 completed 30-day follow-up
- Participants
- 9,755 women
- Comparison
- Intervention vs Control
- Interventionn = 4,656
- Controln = 5,099reference
- Primary endpoint
- Surgical site infection rate
- Follow-up
- 30 days postoperatively
Methodological detailsstepped-wedge, cluster randomised, multicentre
- Stepped-wedge
- Cluster randomised
- Multicentre
Primary result
Surgical site infection · 30 days
Odds ratio
0.84
95% CI 0.55–1.27
P = 0.40
Intervention vs Control
OR 0.84 (95% CI 0.55–1.27); P = 0.40
As reported in the abstract
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Compliance with ≥5 of 6 intraoperative infection prevention standards | 2.95 (2.40–3.62) | P < 0.001 | |
| 0.20.5125Odds ratio (log scale) |
Maternal mortality, high vs low compliance (regardless of arm)
| OR (95% CI) | P value | ||
|---|---|---|---|
| High compliance | 0.32 (0.11–0.93) | P = 0.04 | |
| 0.10.31310Odds ratio (log scale) |
Perinatal mortality, high vs low compliance (regardless of arm)
| OR (95% CI) | P value | ||
|---|---|---|---|
| High compliance | 0.64 (0.47–0.89) | P = 0.008 | |
| 0.512Odds ratio (log scale) |
Original publication
A Perioperative Quality Improvement Program for Cesarean Delivery in Ethiopia: A Stepped-Wedge Cluster Randomized Clinical Trial. JAMA Netw Open. Published 1 August 2024. doi:10.
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