Observational studyBMJ open2018
Temporal trends in severe maternal and neonatal trauma during childbirth: a population-based observational study.
Observational study in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Local cooling for relieving pain from perineal trauma sustained during childbirth.The Cochrane database of systematic reviews · 2020Pooled it
- Article
- Neonatal birth trauma: identifying new risk factors and short-term outcomes.Frontiers in pediatrics · 2025Article
- Obstetric claims in Finland 2012-2022-A nationwide patient insurance registry study.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Severe birth injuries in neonates and associated risk factors for injury in mothers with different types of diabetes in Finland.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2022Article
- Factors associated with 5-min APGAR score, death and survival in neonatal intensive care: a case-control study.BMC pediatrics · 2022Article
- Article
- Surface electromyography of the pelvic floor at 6-8 weeks following delivery: a comparison of different modes of delivery.International urogynecology journal · 2022Article
- Complications of instrumental vaginal deliveries and associated factors in hospitals of Western Oromia, Ethiopia.SAGE open medicine · 2022Article
- Maternal and Neonatal Outcomes of Operative Vaginal Deliveries at a Single Tertiary Center.Oman medical journal · 2021Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveInstrumental vaginal delivery is associated with birth trauma to infant and obstetric trauma to mother. As caesarean delivery rates increased during the past decades, the rate of instrumental vaginal delivery declined. We examined concomitant temporal changes in the rates of severe birth trauma and maternal obstetric trauma.
designA retrospective observational study. SETTINGS AND
participantsAll hospital singleton live births in Washington State, USA, 2004-2013, excluding breech delivery. Severe birth trauma (brain, nerve injury, fractures and other severe birth trauma) and obstetric trauma (third/fourth degree perineal lacerations, cervical/high vaginal lacerations) were identified from hospitalisation data. Pregnancy and delivery characteristics were obtained from birth certificates. Temporal trends were assessed by the Cochran-Armitage test. Logistic regression was used to obtain adjusted ORs (AORs) and 95% CI.
resultsOverall, 732 818 live births were included. The rate of severe birth trauma declined from 5.3 in 2004 to 4.5 per 1000 live births in 2013 (P<0.001). The decline was observed only in spontaneous vaginal delivery, the rates of fractures and other severe birth trauma declined by 5% and 4% per year, respectively (AOR: 0.95, 95% CI 0.94 to 0.97 and AOR: 0.96, 95% CI 0.93 to 0.99; respectively). The rate of third/fourth degree lacerations declined in spontaneous vaginal delivery from 3.5% to 2.3% (AOR: 0.95; 95% CI 0.94 to 0.95) and in vacuum delivery from 17.3% to 14.5% (AOR: 0.97, 95% CI 0.96 to 0.98). Among women with forceps delivery, these rates declined from 29.8% to 23.4% (AOR: 0.98, 95% CI 0.96 to 1.00).
conclusionWhile the rates of fractures and other birth trauma declined among infants delivered by spontaneous vaginal delivery, the rate of birth trauma remained unchanged in instrumental vaginal delivery and caesarean delivery. Among mothers, the rates of severe perineal lacerations declined, except for women with forceps delivery.
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