ArticleThe Lancet regional health. Western Pacific2022
A nationwide cross-sectional survey of episiotomy practice in China.
Article in The Lancet regional health. Western Pacific, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Prevalence of Episiotomy Practice and Associated Factors in Brazil: A Systematic Review.Birth (Berkeley, Calif.) · 2026Pooled it
- Incidence, temporal trends and risk factors of puerperal infection in Mainland China: a meta-analysis of epidemiological studies from recent decade (2010-2020).BMC pregnancy and childbirth · 2023Pooled it
- Episiotomy Practice and Its Associated Factors in Africa: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Prevalence of episiotomy practice and factors associated with it in Ethiopia, systematic review and meta-analysis.Women's health (London, England)Pooled it
- The Effect of Perineum Massage Applied With and Without an Instrument in the Active Phase of Labor Birth Outcomes: A Randomized Clinical Trial.International urogynecology journal · 2024Trial
- Impact of Episiotomy on Postpartum Pain, Pelvic Floor Function, and Sexual Health: A Propensity Score-Matched Cohort Study and Prediction Model Development.International urogynecology journal · 2026Article
- Validity and reliability of the Chinese version of the Barriers to Physical Activity during Pregnancy Scale (BPAPS) in pregnant women.BMC pregnancy and childbirth · 2026Article
- Effects of hand preference on learning episiotomy skills: a study conducted with midwifery students.BMC nursing · 2026Article
- Selective episiotomy guided by a perineal evaluation form for forceps-assisted vaginal delivery: a retrospective cohort study on maternal and neonatal outcomes.BMC pregnancy and childbirth · 2026Article
- Article
- Analysis of risk factors and prediction model construction for poor healing of perineal wounds after vaginal delivery: A retrospective case-control study.International journal of nursing studies advances · 2025Article
- The Effectiveness of Virtual Reality Application for Women Undergoing Episiotomy Repair: A Systematic Review and Meta-analysis.Journal of caring sciences · 2024Article
- Prevalence and predictors of episiotomy among puerperal women accessing postnatal care in the Kumasi Metropolis.BMC pregnancy and childbirth · 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
- Obstetric Interventions Among Native and Migrant Women: The (Over)use of Episiotomy in Portugal.International journal of public health · 2024Article
- The effect of music-based interventions on short-term postpartum episiotomy pain: A systematic review and meta-analysis.Heliyon · 2023Review
- Perineal stress as a predictor of performing episiotomy in primiparous women: a prospective observational study.BMC pregnancy and childbirth · 2022Observational
- Episiotomy practice and perineal trauma in the Philippines.The Lancet regional health. Western Pacific · 2022Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA restrictive use of episiotomy was recommended by the obstetric society in China, but limited information on the epidemiology and the effects of restrictive use of episiotomy on maternal and fetal outcomes have been published.
methodsThe China Labor and Delivery Survey is a cross-sectional investigation with a cluster random sampling scheme in 2015-2016 with the aim to describe detailed epidemiology of labor and delivery in China. We calculated the episiotomy rate by parity using the survey data. Associated factors of episiotomy were selected using mixed models with a random effect for the hospital-level clustering. Logistic regression models were fitted to examine the effects of mediolateral episiotomy on maternal and neonatal outcomes among the propensity score-matched women.
findingsThe episiotomy rate among vaginal births was 41·7% [95% confidence interval (CI): 40·1% - 43·2%] in nulliparae and 21·5% (95% CI: 19·4% - 23·5%) in multiparae in China. Associated factors of episiotomy included prepregnancy BMI, maternal diseases, and obstetric factors. More than half of episiotomies in nulliparae and one-fourth in multiparae had no indications. Mediolateral episiotomy without indicators increased the risk of 3
interpretationEpisiotomy was performed more than medically necessary in China. Mediolateral episiotomy without indications more than doubled the risk of 3
fundingNational Natural Science Foundation of China and Shanghai Health Commission Programme.
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