Evidence map›Paper›PMID 40973367›Full record

ArticleBMJ open2025

Evaluating the prognostic association between race and perineal trauma: a systematic review protocol.

Haifa Hussein Almalki, Fabrice I Mowbray, Susan Buchholz, Ibtihal Alnaimi, Emma C Schlegel, Janis Miller, Jessica Sender

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Haifa Hussein AlmalkiCollege of Nursing, Michigan State University, East Lansing, Michigan, USA almalki8@msu.edu.ORCID http://orcid.org/0000-0002-6480-7263
Fabrice I MowbrayCollege of Nursing, Michigan State University, East Lansing, Michigan, USA.
Susan BuchholzCollege of Nursing, Michigan State University, East Lansing, Michigan, USA.ORCID http://orcid.org/0000-0002-6311-9709
Ibtihal AlnaimiCollege of Nursing, Michigan State University, East Lansing, Michigan, USA.
Emma C SchlegelCollege of Nursing, Michigan State University, East Lansing, Michigan, USA.ORCID http://orcid.org/0000-0002-0242-6561
Janis MillerUniversity of Michigan, Ann Arbor, Michigan, USA.
Jessica SenderCollege of Nursing, Michigan State University, East Lansing, Michigan, USA.ORCID http://orcid.org/0000-0001-9249-4981

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPerineal trauma is one of the most common complications of childbirth, impacting approximately 9 out of 10 women who undergo a vaginal delivery. Perineal trauma is a public health issue leading to increased maternal morbidity and decreased quality of life. Although race is being studied as a potential risk factor and predictor of perineal trauma, other contributing factors like racism and social determinants of health have not been adequately studied in the same context. We set out to synthesise the available peer-reviewed evidence evaluating the prognostic association between race and perineal trauma. METHODS AND ANALYSIS: This systematic review and meta-analysis adheres to the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) and PROGRESS (Prognosis Research Strategy) guidelines and is registered with PROSPERO. The review explores the association between racial status (non-Hispanic white vs non-white) and perineal birth trauma using the PECOTS (Population, Intervention/Exposure, Comparator, Outcome, Timing and Setting) framework. We will search PubMed, CINAHL, Web of Science and Embase. Peer-reviewed observational studies will be included. Data extraction and screening will be done in duplicate. Analyses will use random-effects models in R, reporting both unadjusted and adjusted risk differences. Risk of bias will be assessed using ROBINS-I (Risk of Bias in Non-randomised Studies of Interventions). Heterogeneity and certainty of evidence will be evaluated using I² and GRADE (Grading of Recommendations Assessment, Development and Evaluation), respectively. ETHICS AND DISSEMINATION: This is a systematic review based on previously published data, and therefore ethical approval is not required. The findings of this review will be disseminated through publication in a peer-reviewed journal and presented at academic conferences. PROSPERO REGISTRATION NUMBER: CRD42025590093.

Indexed as

Delivery, ObstetricObstetric Labor ComplicationsPerineumRacial GroupsFemaleHumansMeta-Analysis as TopicPregnancyPrognosisResearch DesignRisk FactorsSystematic Reviews as TopicMeta-AnalysisNatural ChildbirthPostpartum WomenTrauma

Identifiers

PMID40973367
PMCPMC12458755

What OpenQuestion holds

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Registered trials

None linked

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.