Obstetrical Soft Tissue Trauma during Spontaneous Vaginal Birth in the Romanian Adolescent Population—Multicentric Comparative Study with Adult Population

Abstract

Romania is a country with high rates of adolescent births, associating scarce comprehensive obstetrical management with this specific population. This research aims to assess soft tissue trauma after vaginal birth in teenage mothers compared to their adult counterparts. A retrospective case-control study was conducted for one year in two hospitals. All vaginal deliveries were considered; the age cut-off value was considered at 20 years old for case and control groups. Lacerations were divided into three subgroups, considering the involved anatomical region; group I: labial and periurethral lacerations, group II: vaginal and perineal lacerations, and group III: cervical lacerations. There were 1498 women included in the study: 298 young mothers and 1200 adults. Teenagers were more likely to have an episiotomy during vaginal delivery compared to adult women: 56% versus 26.7% (p = 0.00, Pearson Chi-square) and a 1.89 times increased risk for developing additional group II lacerations: p = 0.01, Pearson Chi-square test with Bonferroni correction: OR = 1.89, 95% CI: 1.18–3.02. Group II lacerations were the most frequent type of birth trauma in both study groups. Fetal weight ≥4000 g was associated with a two times higher risk for vaginal and perineal lacerations when age criterion was not considered (OR = 1.98, 95% CI: 1.13–3.47, p = 0.01). The incidence of group I and II lacerations increased with age: from 0% and 9.1% between 10 and 14 years old to 6% and 26.2% between 18 and 19 years old. All groups of lacerations were more often identified in the case group, compared to the adult group. Fetal macrosomia and spontaneously ruptured membranes at admission could not be documented as risk factors for obstetrical injury in young mothers. Episiotomy performed in teenagers was not a protective procedure for group II lacerations.

[Retracted] Mechanism of Anti‐Inflammatory Drugs in the Early Treatment of Oral Gingival Mucosa and Soft Tissue Trauma

“…He assessed clinical features, outcomes of diagnostic modalities, and initial response to therapy to determine their usefulness in predicting SI [ 1 ]. Matei et al conducted a one-year retrospective case-control study at two hospitals to evaluate soft tissue trauma after vaginal delivery in adolescent mothers compared with adult mothers [ 2 ]. Hampp et al compared the extent of soft tissue trauma maintained by robotic arm-assisted PKA and manual PKA in knee arthroplasty [ 3 ].…”

Prevalence and factors associated with the perception of perineal laceration: a cross-sectional study with data from the Nascer no Brasil Survey, 2011 and 2012

“…These results are in keeping with the results of a retrospective study carried out in Romania with 1,498 parturient women, of whom 298 were adolescents, between 2020 and 2021, which found 89% higher odds of laceration among adolescents when compared to adults. 10 Greater f requency of perineal laceration during adolescence can be attributed to the immaturity of pelvic bone growth and muscle development, leading to a reduction in the internal diameters of the pelvis and the muscular strength of the pelvic floor, increasing the risk of adverse birth outcomes, such as perineal laceration. 11 We found that living in the North and Northeast regions of Brazil was associated with lower prevalence of laceration based on the perception of the postpartum women.…”

Prevalência e fatores associados à percepção da laceração perineal: estudo transversal com dados do Inquérito Nascer no Brasil, 2011 e 2012

“…Esses resultados concordam com resultados de um estudo retrospectivo realizado na Romênia com 1.498 parturientes, das quais 298 adolescentes, entre 2020 e 2021, que observou chance de laceração 89% maior entre as adolescentes quando comparadas às adultas. 10 A maior frequência de laceração perineal durante a adolescência pode ser atribuída à imaturidade do crescimento ósseo pélvico e do desenvolvimento muscular, propiciando redução dos diâmetros internos da pelve e da força muscular do AP, aumentando risco de desfechos adversos no parto, como a laceração perineal. 11 Observou-se que residir nas regiões Norte e Nordeste do país esteve associada à menor prevalência de laceração baseada na percepção da puérpera.…”