ArticleBMC pregnancy and childbirth2017
Duration of second stage of labor and instrumental delivery as risk factors for severe perineal lacerations: population-based study.
Article in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05579808 (The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson's Classes), which is not on this map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson's Classes: a Propensity Score-matched Analysis
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- Evaluating the impact of the second-stage and pushing duration on maternal and neonatal outcomes: a systematic review and meta-analysis.American journal of obstetrics and gynecology · 2025Pooled it
- Selective episiotomy versus no episiotomy for severe perineal trauma: a systematic review with meta-analysis.International urogynecology journal · 2020Pooled it
- Investigating the association factors of acute postpartum pain: a cohort study.BMC anesthesiology · 2023Trial
- Perineal Care Strategies and Perineal Outcomes in Primiparous Women: A Prospective Observational Pilot Study.Medical sciences (Basel, Switzerland) · 2026Observational
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Free positions in the second stage of labor for pelvic floor protection: a narrative review.Frontiers in medicine · 2026Review
- The association between fetal head malrotation and labor analgesia: a propensity score-matched analysis.BMC pregnancy and childbirth · 2025Article
- Article
- Perspective on Perinatal Birth Canal Injuries: An Analysis of Risk Factors, Injury Mechanisms, Treatment Methods, and Patients' Quality of Life: A Literature Review.Journal of clinical medicine · 2025Review
- Episiotomy and severe perineal laceration among Asian American, Native Hawaiian, and Pacific Islander nulliparous individuals in California.AJOG global reports · 2025Article
- Association between labor duration in transvaginal deliveries and the risk of neonatal intensive care unit admission for newborns.Frontiers in pediatrics · 2025Article
- Is epidural analgesia an independent risk factor for OASIS? A population-based cohort study.Archives of gynecology and obstetrics · 2024Article
- Could a simple manual technique performed by a midwife reduce the incidence of episiotomy and perineal lacerations? A non-randomized pilot study.European journal of midwifery · 2024Article
- Prevalence of episiotomy and associated factors among women who gave birth at public health facilities in Jigjiga town, eastern Ethiopia: A cross-sectional study.PLOS global public health · 2024Article
- Sexual dysfunction and its associated factors among reproductive-age women at Gurage Zone, Southern Ethiopia, 2023.BMC public health · 2023Article
- The Impact of Maternal Position in Labor on Occiput-Posterior Position of Fetus and Pregnancy Outcomes in Pregnant Women Without Epidural Analgesia.Journal of family & reproductive health · 2023Article
- Risk factors associated with severe perineal lacerations during vaginal delivery: a 10-year propensity score-matched observational study.AJOG global reports · 2023Article
- Management of Third and Fourth-Degree Perineal Tears After Vaginal Birth. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/079, December 2020).Geburtshilfe und Frauenheilkunde · 2023Article
- Maternal Complications Related to Operative Vaginal Delivery and Their Associated Factors among Women Delivered at NEMCS Hospital, Southwest Ethiopia.Obstetrics and gynecology international · 2023Article
- The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson's Classes: A Propensity Score-Matched Analysis.Journal of clinical medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe sought to investigate the impact of the duration of second stage of labor on risk of severe perineal lacerations (third and fourth degree).
methodsThis population based cohort study was conducted in the Stockholm/Gotland region, Sweden, 2008-2014. Study population included 52 211 primiparous women undergoing vaginal delivery with cephalic presentation at term. Unconditional logistic regression analysis was used to calculate crude and adjusted odds ratios (OR), using 95% confidence intervals (CI). Main exposure was duration of second stage of labor, and main outcome was risks of severe perineal lacerations (third and fourth degree).
resultsRisk of severe perineal lacerations increased with duration of second stage of labor. Compared with a second stage of labor of 1 h or less, women with a second stage of more than 2 h had an increased risk (aOR 1.42; 95% CI 1.28-1.58). Compared with non-instrumental vaginal deliveries, the risk was elevated among instrumental vaginal deliveries (aOR 2.24; 95% CI 2.07-2.42). The risk of perineal laceration increased with duration of second stage of labor until less than 3 h in both instrumental and non-instrumental vaginal deliveries, but after 3 h, the ORs did not further increase. After adjustments for potential confounders, macrosomia (birth weight > 4 500 g) and occiput posterior fetal position were risk factors of severe perineal lacerations.
conclusionsThe risk of severe perineal laceration increases with duration until the third hour of second stage of labor. Instrumental delivery is the most significant risk factor for severe lacerations, followed by duration of second stage of labor, fetal size and occiput posterior fetal position.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.