Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study

Background In view of the reported increase in obstetric anal sphincter injuries, the objective of this study was to evaluate the incidence of such injuries over time and the associated risk and protective factors. Methods This was a retrospective cohort study from a national database of 168 137 pri...

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Bibliographic Details
Published in:Birth (Berkeley, Calif.) Calif.), 2018-12, Vol.45 (4), p.409-415
Main Authors: Marschalek, Marie‐Louise, Worda, Christof, Kuessel, Lorenz, Koelbl, Heinz, Oberaigner, Willi, Leitner, Hermann, Marschalek, Julian, Husslein, Heinrich
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anal Canal - injuries
Austria - epidemiology
Birth injuries
Birth weight
Cesarean section
Childbirth & labor
Cohort analysis
Colon
Databases, Factual
Delivery, Obstetric - statistics & numerical data
Delivery, Obstetric - trends
Episiotomy
Episiotomy - statistics & numerical data
Episiotomy - trends
Female
Gynecology
Health risk assessment
Humans
Injuries
Labor, Obstetric - physiology
Logistic Models
Multivariate Analysis
Number needed to treat
obstetric anal sphincter injury
Obstetric Labor Complications - epidemiology
Obstetric Labor Complications - prevention & control
Obstetrics
Original
Perineum - injuries
Pregnancy
Protective Factors
Retrospective Studies
Risk Factors
Vaginal birth
Women
Young Adult
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Summary:Background In view of the reported increase in obstetric anal sphincter injuries, the objective of this study was to evaluate the incidence of such injuries over time and the associated risk and protective factors. Methods This was a retrospective cohort study from a national database of 168 137 primiparous women with term, singleton, cephalic, vaginal delivery between 2008 and 2014. The main outcome measure was obstetric anal sphincter injury. A multivariate regression model was used to identify risk and protective factors. Results Age >19 years, birthweight >4000 g, and operative vaginal delivery were independent risk factors for obstetric anal sphincter injuries. Mediolateral episiotomy increased the risk for obstetric anal sphincter injuries in spontaneous vaginal birth (number needed to harm 333), whereas it was protective in vacuum delivery (number needed to treat 50). From 2008 to 2014, there was an increase in the rate of obstetric anal sphincter injuries (2.1% vs 3.1%, P 
ISSN:0730-7659
1523-536X
DOI:10.1111/birt.12346