ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026
Impact of gestational weight gain on perineal injury and obstetric anal sphincter injury among underweight primiparous women.
Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Inflammatory bowel disease and risk of perineal injury in primiparous vaginal births: a retrospective cohort study.Inflammatory bowel diseases · 2026Article
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7 authors.
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Abstract
objectiveTo evaluate the association between gestational weight gain (GWG) and perineal trauma in primiparous women with a pre-pregnancy body mass index (BMI) <18.5.
methodsThis retrospective cohort study included primiparous women with singleton, vertex deliveries at a tertiary medical center (2012-2023). GWG was categorized per Institute of Medicine guidelines: below (<12.5 kg, Group A), within (12.5-18 kg, Group B), and above (>18 kg, Group C). Exclusions included preterm birth, age <18 or >45, multiple gestations, stillbirths, pregnancy terminations, pregestational and gestational diabetes. The primary outcome was the rate of overall perineal injury, including all degrees of spontaneous perineal lacerations, labial tears, and episiotomy, and the secondary outcome was Obstetric anal sphincter injury (OASI).
resultsAmong 4034 eligible women, 49.0% were in Group A, 39.0% in Group B, and 12.0% in Group C. No significant differences were observed between GWG groups in rates of lacerations, episiotomy, or perineal repair. OASI rates were similar across all groups (1.0%-1.1%). In multivariate analysis, GWG below (odds ratio [OR] = 1.177, 95% confidence interval [CI]: 0.974-1.423) or above (OR = 1.057, 95% CI: 0.784-1.424) the recommended range was not associated with increased risk of perineal trauma. However, epidural use (OR = 1.519, P < 0.001), vacuum-assisted delivery (OR = 3.876, P < 0.001), and higher birth weight (OR = 2.124 per kg, P < 0.001) were significant risk factors. Higher BMI within the underweight range (OR = 0.855, P = 0.012) and smoking (OR = 0.569, P = 0.001) were protective.
conclusionAmong underweight primiparous women, GWG does not significantly impact the risk of perineal trauma. Epidural use, vacuum-assisted delivery, and higher birth weight increase risk, while higher BMI within the underweight range and smoking are associated with reduced risk.
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