CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-07). The draft was written by AI, the existence of all 4 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.7.
Verdict No. 2402 · Search date 2026-08-07 · Methodology v0.7

Preincision cefazolin,
does it really help with Prevention of maternal infection versus the same antibiotic after cord clamping?

30-Second Summary
C
Evidence Grade C · 56 · Safety caution
Both groups received antibiotics, and pooled evidence favored preincision dosing for maternal infection
Cephalosporin allergy and antibiotic adverse effects require attention. Neonatal sepsis and sepsis workup did not differ; neonatal antibiotic treatment was reported in only one trial with 90 neonates.
What the
research shows
The grade is C. Both comparison arms received prophylactic antibiotics. A Cochrane synthesis of 10 randomized trials and 5,041 women found lower primary composite maternal infectious morbidity with preincision dosing, RR 0.57 (95% CI 0.45 to 0.72).
What the
ads claim
State clearly that both timing arms received the same drug and dose.
*

Useful facts when choosing a product

  • Both timing arms received the same prophylactic intravenous antibiotic within each trial; both Witt timing arms received cefazolin 2 g.
  • The pooled primary outcome was composite maternal infectious morbidity.
  • Neonatal sepsis and sepsis workup were null; neonatal antibiotic treatment was reported in one trial with 90 neonates, RR 0.84 (95% CI 0.12 to 5.68).
Gap Measurement · Verdict 2402 · C 56
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Cochrane pooled 10 randomized trials and 5,041 women through March 2014. Both arms received prophylactic intravenous antibiotics; only timing differed. The primary composite maternal morbidity RR was 0.57 (95% CI 0.45 to 0.72), endometritis RR 0.54 (0.36 to 0.79), and surgical-site infection RR 0.59 (0.44 to 0.81). Neonatal sepsis was reported in five trials and 2,907 neonates, RR 0.76 (0.51 to 1.13); sepsis workup in four trials and 1,170 neonates, RR 0.92 (0.69 to 1.23); and neonatal antibiotic treatment in one trial and 90 neonates, RR 0.84 (0.12 to 5.68). Exact heterogeneity values for these three neonatal outcomes and the review's original funding and conflict-of-interest wording could not be verified. Trials with unclear allocation concealment and high or unclear blinding risk were included.

02

Why this is classified as C (56)

Pooled maternal benefit with unclear allocation concealment and high or unclear blinding risk gives C with 56 points.

Counterpoint. This does not refute antibiotic prophylaxis itself.

Rejudgment record. Cross-check applied — Pooled benefit across 10 randomized timing trials with prophylactic antibiotics in both arms

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationR1Single confirmatory trial
IndependenceI1Mixed funding sources
Effect sizeE+Meets the clinically important threshold

The scoring table and the verdict agree (C).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Prevention of composite maternal infectionCThe pooled RR across 10 trials was 0.57 (95% CI 0.45 to 0.72).

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Double-blind three-arm randomized trial1,112No separate funding statement; Financial Disclosure: None reportedComposite wound infection, endometritis, or urinary infection18/370 versus 14/371; risk difference 1.1 points (95% CI -1.8 to 4.0)Pivotal timing comparison
Study 2Systematic review and meta-analysis of randomized trials5,041The review's original funding and conflict-of-interest wording could not be verifiedPrimary composite maternal infectious morbidity; endometritis; surgical-site infectionRR 0.57 (0.45-0.72); 0.54 (0.36-0.79); 0.59 (0.44-0.81)Pooled estimate of the complete randomized evidence
Study 3Systematic review and meta-analysis of randomized trials7,131Could not be verified from the accessible abstractEndometritis; wound complications; neonatal sepsisRR 0.52 (0.37-0.72); 0.54 (0.42-0.69); 0.83 (0.61-1.14)Broadest updated randomized evidence
§

Receipt — 4 References

All 4 cited sources were verified for existence at the original page (as of 2026-08-07).

Witt A, Döner M, Petricevic L, et al. Antibiotic Prophylaxis Before Surgery vs After Cord Clamping in Elective Cesarean Delivery. Arch Surg. 2011;146(12):1404-1409. DOI: 10.1001/archsurg.2011.731.
checked
Mackeen AD, Packard RE, Ota E, Berghella V, Baxter JK. Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing cesarean delivery. Cochrane Database Syst Rev. 2014;(12):CD009516. DOI: 10.1002/14651858.CD009516.pub2.
checked
Baaqeel H, Baaqeel R. Timing of administration of prophylactic antibiotics for caesarean section: a systematic review and meta-analysis. BJOG. 2013;120(6):661-669. PMID: 23126271. DOI: 10.1111/1471-0528.12036.
checked
Zeng S, Liu Y, Chen M, Ruan T, Lu W, Liu X. Timing of Intravenous Prophylactic Antibiotic Agents for Cesarean Delivery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Surg Infect (Larchmt). 2023;24(4):303-310. PMID: 37126077. DOI: 10.1089/sur.2022.389.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-07 · Corrections: none

Cite this verdict

Preincision cefazolin x postcesarean infection versus dosing after cord clamping Evidence Grade C card
[Chamgap] Preincision cefazolin x postcesarean infection versus dosing after cord clamping — Evidence Grade C·56. 4 cited sources checked. Source: https://chamgap.com/en/verdicts/womens/cesarean-preincision-versus-cord-clamping-cefazolin-infection/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

!

What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.