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Risks with Obstetric Clostridium difficile Infection

Obstet Gynecol; ePub 2018 Jan 9; Ruiter-Ligeti, et al

A diagnosis of Clostridium difficile (C. difficile) infection in pregnancy has increased over the past 15 years, a recent study found, with the diagnosis associated with significant maternal morbidity and mortality. This according to a retrospective cohort study of US women between 1999 and 2013 that assessed risk factors for the diagnosis of C. difficile infection. Among the details:

  • A total of 13,881,592 births were identified in the cohort, with 2,757 (0.02%) admissions for delivery complicated by a diagnosis of C. difficle infection.
  • During the study period, the rate of C. difficle infection diagnoses among women hospitalized for delivery doubled from 15 to 30 per 100,000 deliveries per year.
  • Risk factors associated with the diagnosis of C. difficle infection included aged >35 years, multiple gestations, smoking, Crohn’s disease, ulcerative colitis, long-term antibiotic use, pneumonia, pyelonephritis, as well as cesarean or perineal wound infection.
  • The diagnosis of C. difficle infection in pregnancy was associated with a significant increase in maternal death.


Ruiter-Ligeti J, Vincent S, Czuzoj-Shulman N, Abenhaim HA. Risk factors, incidence, and morbidity associated with obstetric Clostridium difficile infection. [Published online ahead of print January 9, 2018]. Obstet Gynecol. doi:10.1097/AOG.0000000000002422.