Effect of body mass index on the incidence of perineal trauma

Durnea, Constantin M.; Jaffery, Ali Emad; Gauthaman, Nivedita; Doumouchtsis, Stergios K.

doi:10.1002/ijgo.12403

Cited by 19 publications

(23 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only a few studies are available that evaluated the impact of obesity on perineal trauma. However, in contrast to our findings, the studies reported obesity as a protective factor against both mild and severe forms of perineal injury [ 20 , 22 ]. The risk estimate of perineal tear in the study is consistent with the studies conducted in Slovenia and Saudi Arabia [ 21 , 41 ].…”

Section: Discussioncontrasting

confidence: 99%

“…However, the reported associations are inconsistent. A few studies have reported that overweight is protective against perineal trauma [ 20 , 22 ], while others have suggested high risk for perineal injury [ 21 , 23 ]. Several studies, mainly from high-income countries, have investigated the impact of obesity on PPH and have reported a small [ 24 , 26 ] to a moderate increase of PPH odds [ 27 , 28 ] in obese women compared to the normal-weight women.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Body mass index in early-pregnancy and selected maternal health outcomes: Findings from two cohorts in Bangladesh

Rahman¹,

Rahman²,

Pervin³

et al. 2020

Journal of Global Health

View full text Add to dashboard Cite

Background Maternal nutrition is one of the most influential factors that affect the health of the mother and her offspring and remains a significant public health challenge globally. There is a lack of studies evaluating the trends of maternal nutrition and its impact on the burden of pregnancy complications from low-income countries, including Bangladesh. We aimed to determine the burden of early-pregnancy nutrition status based on body mass index (BMI), and the associations of nutritional status with pregnancy-induced hypertension (PIH), cesarean section (CS) delivery, perineal tear and postpartum hemorrhage (PPH) in a rural area in Bangladesh. Methods This prospective study analyzed data from two cohorts: the Maternal, Neonatal, and Child Health (MNCH) project carried out from January 2008 to June 2010, and the Preterm and Stillbirth Study, Matlab (PreSSMat) conducted from October 2015 to March 2018. In total, information of 9287 women who gave birth from the two cohorts was available for analysis. Early-pregnancy BMI was categorized into underweight, normal-weight, and overweight groups. The change in the burden of malnutrition between two cohort periods and the associations between women’s BMI and maternal health outcomes were presented in odds ratios (ORs) with their 95% confidence interval (CI). Results Between the two cohort periods, the prevalence of underweight decreased from 17.5% to 15.4%, and overweight increased from 10.8% to 20.9%. The risk of being overweight in pregnant women was about two times (OR = 2.19; 95% CI = 1.94-2.46) higher in the PreSSMat cohort than in the MNCH cohort. After multivariate-adjustment for socio-demographic factors, the pooled ORs of PIH, CS delivery, perineal tear, and PPH were 2.41 (95% CI = 1.95-2.99), 2.12 (95% CI = 1.86-2.41), 2.46 (95% CI = 1.54-3.92), and 1.68 (95% CI = 1.12-2.53), respectively, in women with overweight compared to the normal-weight group. Conclusions The results confirmed the existence of a double burden of malnutrition in rural women in Bangladesh. Women with overweight had an increased risk of selected pregnancy complications. The findings call for the adoption of appropriate prenatal counseling and preparedness tailored to women’s nutritional status to prevent possible adverse health outcomes.

show abstract

Section: Discussioncontrasting

confidence: 99%

mentioning

confidence: 99%

Body mass index in early-pregnancy and selected maternal health outcomes: Findings from two cohorts in Bangladesh

Rahman¹,

Rahman²,

Pervin³

et al. 2020

Journal of Global Health

View full text Add to dashboard Cite

show abstract

“…The risk of episiotomy was lower in women who have had an increased BMI [ 48 ]. An increased BMI at enrolment was associated with a reduced incidence of minor perinatal trauma at delivery [ 49 ]. Obese women were less likely to use tobacco, were more likely to have their labor augmented or induced with oxytocin, and had shorter second stages than women who were not obese [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Magnitude of Episiotomy and Associated Factors among Mothers Who Give Birth in Arba Minch General Hospital, Southern Ethiopia: Observation-Based Cross-Sectional Study

Fikadu

Boti

Tadesse

et al. 2020

Journal of Pregnancy

View full text Add to dashboard Cite

Background. Episiotomy is the most common obstetric procedure, performed when the clinical circumstances place the patient at a high risk of high-degree laceration. However, episiotomy should be done with judicious indication to lower perineal laceration with fewer complications. Despite its adverse effects, the magnitude of episiotomy is increasing due to different factors. Therefore, this study is aimed at determining the recent magnitude of episiotomy and at identifying associated factors among women who gave delivery in Arba Minch General Hospital, Southern Ethiopia. Methods. An institution-based cross-sectional study was conducted from December 15, 2018, to January 30, 2019. A systematic random sampling technique was used to select study participants. A semistructured questionnaire was used to collect data. This was supplemented with a review of the labor and delivery records. Binary and multivariable logistic regression analyses were performed to identify factors associated with the magnitude of episiotomy. P value ≤ 0.05 was used to determine the level of statistically significant variables. Results. The magnitude of episiotomy was found to be 272 (68.0%) with 95%CI=64.0‐72.5. Women who attended secondary education [AOR=10.24, 95%CI=2.81‐37.34], women who attended college and above [AOR=4.61, 95%CI=1.27‐16.71], birth weight≥3000 g [AOR=4.84, 95%CI=2.66‐8.82], primipara [AOR=4.13, 95%CI=2.40‐7.12], being housewife occupants [AOR=3.43, 95%CI=1.20‐9.98], married women [AOR=2.86, 95%CI=1.40‐5.84], and body mass index<25 kg/m2 [AOR=2.85, 95%CI=1.50‐5.44] were independent variables found to have significant association with episiotomy. Conclusion. The magnitude of episiotomy was 68.0% which is higher than the recommended practice by WHO (10%). The study participants’ occupational status, marital status, educational status, parity, birth weight, and BMI were significantly associated with the magnitude of episiotomy in the study area. Therefore, to reduce the rate of episiotomy, it is better to have periodic training for birth attendants regarding the indication of episiotomy.

show abstract

“…This is in accordance with recently published United Kingdom data, which report that higher BMI is protective for minor perineal trauma, but not for obstetric anal sphincter injuries. 39 Other studies, however, suggest that higher BMI is protective for obstetric anal sphincter injuries. 13,40 Birth position did not influence the rate of obstetric anal sphincter injuries in our study.…”

Section: Adjusted a Or (95% Ci)mentioning

confidence: 98%

Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study

Marschalek

Worda

Kuessel

et al. 2018

Birth

View full text Add to dashboard Cite

BackgroundIn view of the reported increase in obstetric anal sphincter injuries, the objective of this study was to evaluate the incidence of such injuries over time and the associated risk and protective factors.MethodsThis was a retrospective cohort study from a national database of 168 137 primiparous women with term, singleton, cephalic, vaginal delivery between 2008 and 2014. The main outcome measure was obstetric anal sphincter injury. A multivariate regression model was used to identify risk and protective factors.ResultsAge >19 years, birthweight >4000 g, and operative vaginal delivery were independent risk factors for obstetric anal sphincter injuries. Mediolateral episiotomy increased the risk for obstetric anal sphincter injuries in spontaneous vaginal birth (number needed to harm 333), whereas it was protective in vacuum delivery (number needed to treat 50). From 2008 to 2014, there was an increase in the rate of obstetric anal sphincter injuries (2.1% vs 3.1%, P < .01), vacuum deliveries (12.1% vs 12.8%, P < .01), and cesarean delivery after labor (17.1% vs 19.4%, P < .01), while forceps deliveries (0.4% vs 0.1%, P < .01) and episiotomy rate decreased (35.9% vs 26.4%, P < .01).ConclusionsEpisiotomy may be a risk or protective factor depending on the type of episiotomy and the clinical setting in which it is used. Our study supports a restrictive use of mediolateral episiotomy in spontaneous vaginal deliveries. In vacuum deliveries mediolateral episiotomy may help prevent obstetric anal sphincter injuries.

show abstract

Effect of body mass index on the incidence of perineal trauma

Abstract: Increased BMI at booking was associated with a reduced incidence of minor perineal trauma at delivery, but was not associated with OASIS.

Cited by 19 publications

References 22 publications

Body mass index in early-pregnancy and selected maternal health outcomes: Findings from two cohorts in Bangladesh

Body mass index in early-pregnancy and selected maternal health outcomes: Findings from two cohorts in Bangladesh

Magnitude of Episiotomy and Associated Factors among Mothers Who Give Birth in Arba Minch General Hospital, Southern Ethiopia: Observation-Based Cross-Sectional Study

Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study

Contact Info

Product

Resources

About