ArticleBirth (Berkeley, Calif.)2018
Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study.
Article in Birth (Berkeley, Calif.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Mediolateral/lateral episiotomy with operative vaginal delivery and the risk reduction of obstetric anal sphincter injury (OASI): A systematic review and meta-analysis.International urogynecology journal · 2022Pooled it
- Randomized, Double-Blind, Placebo-Controlled Trial on the Efficacy of Hyaluronidase in Preventing Perineal Trauma in Nulliparous Women.Yonsei medical journal · 2020Trial
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Incidence and Independent Risk Factors for Obstetric Anal Sphincter Injuries: A Four-Year Retrospective Cohort Study from a UK Tertiary Maternity Unit.Journal of clinical medicine · 2026Article
- Antenatal Anovaginal Distance, a Potential Indicator of Perineal Damage during Pregnancy.Healthcare (Basel, Switzerland) · 2024Article
- Effects of Perineal Warm Compresses during the Second Stage of Labor on Reducing Perineal Trauma and Relieving Postpartum Perineal Pain in Primiparous Women: A Systematic Review and Meta-Analyses.Healthcare (Basel, Switzerland) · 2024Review
- Asian-White disparities in obstetric anal sphincter injury: a systematic review and meta-analysis.AJOG global reports · 2024Review
- Asian-white disparities in obstetric anal sphincter injury: Protocol for a systematic review and meta-analysis.PloS one · 2023Article
- Time trends in episiotomy and severe perineal tears in Portugal: a nationwide register-based study.BMC pregnancy and childbirth · 2022Article
- Substantial Obstetric Anal Sphincter Injury during Vacuum Assisted Delivery: An Obstetrical Issue or Device Related?Journal of clinical medicine · 2022Article
- Can We Predict Feto-Maternal Adverse Outcomes of Vacuum Extraction?Geburtshilfe und Frauenheilkunde · 2022Article
- Obstetric anal sphincter injuries-Maternal, fetal and sociodemographic risk factors: A retrospective register-based study.Acta obstetricia et gynecologica Scandinavica · 2022Observational
- The clinical characteristics of perineal tears: A study carried out on 14 pregnant women in a tertiary center: Case series.Annals of medicine and surgery (2012) · 2022Article
- Could Subtle Obstetrical Brachial Plexus Palsy Be Related to Unilateral B Glenoid Osteoarthritis?Journal of clinical medicine · 2021Article
- Women's experience and satisfaction with midwife-led maternity care: a cross-sectional survey in China.BMC pregnancy and childbirth · 2021Article
- Impact of a quality improvement project to reduce the rate of obstetric anal sphincter injury: a multicentre study with a stepped-wedge design.BJOG : an international journal of obstetrics and gynaecology · 2021Article
- Delivery Mode after Ileal Pouch-Anal Anastomosis among Pregnant Women with Ulcerative Colitis.Journal of the anus, rectum and colon · 2021Article
- Does birthweight have a role in the effect of episiotomy on anal sphincter injury?Archives of gynecology and obstetrics · 2020Article
- A novel classification for evaluating episiotomy practices: application to the Burgundy perinatal network.BMC pregnancy and childbirth · 2019Article
- Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study.Birth (Berkeley, Calif.) · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 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.
methodsThis 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.
resultsAge >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 < .01), vacuum deliveries (12.1% vs 12.8%, P < .01), and cesarean delivery after labor (17.1% vs 19.4%, P < .01), while forceps deliveries (0.4% vs 0.1%, P < .01) and episiotomy rate decreased (35.9% vs 26.4%, P < .01).
conclusionsEpisiotomy may be a risk or protective factor depending on the type of episiotomy and the clinical setting in which it is used. Our study supports a restrictive use of mediolateral episiotomy in spontaneous vaginal deliveries. In vacuum deliveries mediolateral episiotomy may help prevent obstetric anal sphincter injuries.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.