Evidence map›Paper›PMID 41501520›Full record

ArticleArchives of gynecology and obstetrics2026

Impact of maternal age on the risk of perineal injury and obstetric anal sphincter injury in nulliparous women.

Emmanuel Attali, Daniel Gabbai, Ronen Gold, Asnat Groutz, Yariv Yogev, Yoav Baruch

Abstract read
In one paragraph

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. 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. Review
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

6 authors.

Emmanuel AttaliDepartment of Obstetrics and Gynecology, Lis Maternity Hospital, Lis Hospital for Women's Heath, Sourasky Medical Center, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Weizman 6, Tel Aviv, Israel.
Daniel GabbaiDepartment of Obstetrics and Gynecology, Lis Maternity Hospital, Lis Hospital for Women's Heath, Sourasky Medical Center, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Weizman 6, Tel Aviv, Israel.
Ronen GoldDepartment of Obstetrics and Gynecology, Lis Maternity Hospital, Lis Hospital for Women's Heath, Sourasky Medical Center, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Weizman 6, Tel Aviv, Israel.
Asnat GroutzDepartment of Obstetrics and Gynecology, Lis Maternity Hospital, Lis Hospital for Women's Heath, Sourasky Medical Center, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Weizman 6, Tel Aviv, Israel.
Yariv YogevDepartment of Obstetrics and Gynecology, Lis Maternity Hospital, Lis Hospital for Women's Heath, Sourasky Medical Center, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Weizman 6, Tel Aviv, Israel. yarivyogev@hotmail.com.
Yoav BaruchDepartment of Obstetrics and Gynecology, Lis Maternity Hospital, Lis Hospital for Women's Heath, Sourasky Medical Center, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Weizman 6, Tel Aviv, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe aimed to evaluate the association between maternal age and the incidence of perineal injury including obstetric anal sphincter injuries (OASI) in nulliparous women. STUDY

designA retrospective cohort population-based study was conducted at a tertiary university-affiliated center from January 2011 to December 2020. This study included all nulliparous women with singleton pregnancies at term (37-41 weeks of gestation) in vertex and occiput anterior presentation who received epidural analgesia during labor. Exclusion criteria included stillbirth, chronic and obstetric maternal conditions (hypertension, diabetes mellitus, etc.), and deliveries complicated by instrumental vaginal delivery and episiotomy were excluded. The primary outcome was the incidence of perineal injury, defined as any spontaneous perineal tear, and/or OASI.

resultsDuring the study period, a total of 39,596 nulliparouss women delivered vaginally at our center. Of them 3410 (8.61%) met the inclusion criteria, with 843 (24.7%) in the 20-25 age group and 2567 (75.3%) in the 30-35 age group. Significant differences were observed between the two age groups in terms of ethnicity, maternal weight before pregnancy and at delivery, gestational glucose challenge test results, gestational age at delivery, duration of the second stage of labor, and birth weight. The incidences of perineal injury and OASI were significantly higher in the 20-25 age group compared to the 30-35 age group (perineal injuries: 58% vs. 53.2%; p value: 0.015; OASI: 0.9% vs 0.4%, p value: 0.04). In the multivariable logistic regression analysis assessing the association between maternal age and perineal injury, the overall odds ratio for perineal injury in relation to the younger age category was calculated as 1.22 (CI 1.03-1.44; p value: 0.023), indicating a higher risk of perineal injury in the 20-25 age group compared to the 30-35 age group.

conclusionThis study suggests that younger maternal age is independently associated with an increased risk of perineal injury and OASI among nulliparous women.

Indexed as

Anal CanalDelivery, ObstetricLacerationsMaternal AgeObstetric Labor ComplicationsPerineumAdultFemaleHumansIncidenceParityPregnancyRetrospective StudiesRisk FactorsYoung AdultMaternal ageOASIObstetric Anal Sphincter InjuryPerineal Injury

Identifiers

PMID41501520
PMCPMC12779736

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Registered trials

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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.