Exploring the Relationship Between Endometritis Incidence and Mode of Child Delivery

Objective: : To estimate endometritis rates across delivery methods and analyze associations with maternal and delivery variables in Brazil. Design: : Observational, retrospective cohort study. Setting: : Maternity Hilda Brandão, Santa Casa de Belo Horizonte Hospital, Minas Gerais, Brazil. Population : 35,744 pregnant women admitted for delivery from January 2013 to December 2022. Methods: : Analysis of delivery outcomes across vaginal births (62.1%), forceps deliveries (4%), and cesarean sections (33.9%). Multivariate logistic regression was used to identify factors associated with endometritis. Main Outcome Measures : Endometritis rates by delivery method and associated risk factors. Results: : Overall endometritis rate was 0.6% (224/35,744). Cesarean sections showed 1.34 times higher risk of endometritis compared to vaginal births (p=0.032), with significantly higher risk during labored cesareans (OR=2.297, p<0.001). No significant difference was found between induced and spontaneous labor (OR=1.07, p=0.680). Preterm birth and primiparity were identified as risk factors. Conclusions: : Cesarean delivery, particularly during labor, significantly increases endometritis risk. Maternal comorbidities and previous cesareans showed no significant association with endometritis.