Yildirim 2009.
| Methods | Randomized controlled trial. | |
| Participants | 400 women undergoing elective cesarean delivery prior to labor initially included with 11 excluded due to blood transfusion leaving 389 participants. Additional exclusion criteria included the use of antibiotics in the last 24 hours, pathology that should be treated with antibiotics, pre‐existing maternal disease (such as diabetes, collagen vascular disease, immune system problems), chorioamnionitis, fever on admission, need of transfusion before or during cesarean delivery, ruptured membranes, emergency cesarean delivery and preterm cesarean delivery. | |
| Interventions | 1 g of cefazolin ≤ 45 minutes pre‐incision (n = 194) versus 1 g cefazolin after cord clamp (n = 195). They did not specify intravenous treatment, but we included this trial as it was assumed that cefazolin was administered intravenously. | |
| Outcomes | Rates of postoperative infectious morbidity (endometritis, wound infection, febrile morbidity, UTI), estimated blood loss and operative time. Neonatal outcomes: NICU admission, Apgar score less than 7 at 5 minutes, neonatal sepsis and sepsis workup. |
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| Notes | Conducted June 2007‐December 2007 at 1 hospital inTurkey. | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | 2 parts, blocked randomization. |
| Allocation concealment (selection bias) | Low risk | Sealed, sequentially distributed envelopes indicating group A (pre‐incision) or group B (following cord camp) chosen by the participants, opened by the investigator. |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | This was not specified, but we suspect that no blinding occurred. |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | This was not specified, but we suspect that no blinding occurred. |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | None lost to follow‐ up. |
| Selective reporting (reporting bias) | Low risk | Prespecified outcomes. |
| Other bias | Low risk | No other bias evident. |
BMI: body mass index NICU: neonatal intensive care unit UTI: urinary tract infection