ArticleArchives of gynecology and obstetrics2026
Impact of gestational weight gain on perineal injury in overweight and obese primiparous women.
Article in Archives of gynecology and obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
objectiveOverweight and obesity are associated with adverse pregnancy outcomes, yet higher body mass index (BMI) has paradoxically been linked to reduced risk of perineal lacerations, including obstetric anal sphincter injury (OASI). The role of gestational weight gain (GWG) in this context is not well established. The objective of this study was to evaluate the association between GWG and perineal injury among overweight and obese primiparous women.
methodsA retrospective cohort study was conducted at a tertiary center between 2012-2023, including primiparous women with singleton, term (≥ 37 weeks), vertex vaginal deliveries and pre-pregnancy BMI ≥ 25.0 kg/m
resultsAmong 5,082 deliveries, 13.1% were in Group A, 28.2% in Group B, and 58.7% in Group C. Episiotomy rates were higher in Group C versus Groups A/B (38.7% vs. 34.7%/34.5%; p = 0.011), while overall perineal injury (87.2%-88.5%, p = 0.652) and OASI rates (0.5-1.0%, p = 0.428) did not differ. In multivariate analysis, GWG was not associated with perineal injury. Independent risk factors included epidural analgesia (OR = 1.39, 95% CI 1.10-1.75), vacuum-assisted delivery (VAD) (OR = 2.83, 95% CI 2.07-3.86), higher birthweight (OR = 1.06 per 100 gr., 95% CI 1.03-1.08), and advanced gestational age (OR = 1.13, 95% CI 1.04-1.23).
conclusionGWG was not associated with perineal injury, whereas VAD, epidural analgesia, increased birthweight, and advanced gestational age were independent risk factors.
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