Risk factors for anal sphincter tear in multiparas
To assess maternal, newborn, and obstetric risk factors associated with anal sphincter tear in multiparous women. This case-control study identified 18,779 multiparous vaginal deliveries from 1992 to 2004 from an obstetric automated record database at the University of Alabama at Birmingham. Two hun...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 2006-06, Vol.107 (6), p.1233-1237 |
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| container_title | Obstetrics and gynecology (New York. 1953) |
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| creator | DIPIAZZA, Deann RICHTER, Holly E CHAPMAN, Victoria CLIVER, Suzanne P NEELY, Cherry CHI CHIUNG CHEN BURGIO, Kathryn L |
| description | To assess maternal, newborn, and obstetric risk factors associated with anal sphincter tear in multiparous women.
This case-control study identified 18,779 multiparous vaginal deliveries from 1992 to 2004 from an obstetric automated record database at the University of Alabama at Birmingham. Two hundred eighty-four patients were selected, 145 cases and 139 controls. Variables from the index pregnancy and prior pregnancies were analyzed, and multivariable logistic regression models were constructed to determine significant predictor variables for anal sphincter tear in multiparous women.
One hundred forty-five multiparous women with no history of cesarean delivery sustained a sphincter tear. Multivariable logistic regression showed a significant association with episiotomy (odds ratio [OR] 16.3, 95% confidence interval [CI] 7.7-34.4), shoulder dystocia (OR 7.9, CI 1.6-38), forceps delivery (OR 4.7, CI 2.0-11.2), and being married (OR 2.2, CI 1.1-4.6). A second exploratory model that included variables from previous pregnancies, showed that in addition to episiotomy (OR 34.6, CI 8.8-136), shoulder dystocia (OR 11.1, CI 1.3-95.2), forceps delivery (OR 6.1, CI 1.6-23.5), previous sphincter tear (OR 7.7, CI 1.2-48.7), and second stage of labor greater than 1 hour (OR 6.7, CI 1.1-42.5) were associated with tear.
The strongest clinical risk factors for anal sphincter tear in multiparous women are episiotomy, shoulder dystocia, previous sphincter tear, prolonged second stage of labor, and forceps delivery.
II-2. |
| doi_str_mv | 10.1097/01.AOG.0000217696.25548.ff |
| format | Article |
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This case-control study identified 18,779 multiparous vaginal deliveries from 1992 to 2004 from an obstetric automated record database at the University of Alabama at Birmingham. Two hundred eighty-four patients were selected, 145 cases and 139 controls. Variables from the index pregnancy and prior pregnancies were analyzed, and multivariable logistic regression models were constructed to determine significant predictor variables for anal sphincter tear in multiparous women.
One hundred forty-five multiparous women with no history of cesarean delivery sustained a sphincter tear. Multivariable logistic regression showed a significant association with episiotomy (odds ratio [OR] 16.3, 95% confidence interval [CI] 7.7-34.4), shoulder dystocia (OR 7.9, CI 1.6-38), forceps delivery (OR 4.7, CI 2.0-11.2), and being married (OR 2.2, CI 1.1-4.6). A second exploratory model that included variables from previous pregnancies, showed that in addition to episiotomy (OR 34.6, CI 8.8-136), shoulder dystocia (OR 11.1, CI 1.3-95.2), forceps delivery (OR 6.1, CI 1.6-23.5), previous sphincter tear (OR 7.7, CI 1.2-48.7), and second stage of labor greater than 1 hour (OR 6.7, CI 1.1-42.5) were associated with tear.
The strongest clinical risk factors for anal sphincter tear in multiparous women are episiotomy, shoulder dystocia, previous sphincter tear, prolonged second stage of labor, and forceps delivery.
II-2.</description><identifier>ISSN: 0029-7844</identifier><identifier>EISSN: 1873-233X</identifier><identifier>DOI: 10.1097/01.AOG.0000217696.25548.ff</identifier><identifier>PMID: 16738146</identifier><identifier>CODEN: OBGNAS</identifier><language>eng</language><publisher>New York, NY: Elsevier Science</publisher><subject>Adult ; Anal Canal - injuries ; Biological and medical sciences ; Case-Control Studies ; Delivery, Obstetric - adverse effects ; Delivery. Postpartum. Lactation ; Episiotomy - statistics & numerical data ; Extraction, Obstetrical - adverse effects ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Labor Stage, Second ; Medical sciences ; Parity ; Pregnancy ; Risk Factors ; Time Factors</subject><ispartof>Obstetrics and gynecology (New York. 1953), 2006-06, Vol.107 (6), p.1233-1237</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-e8c8e386e40ccef2d5f8ca7c36fb7de5630e15b426c07064337696ace6408ec33</citedby><cites>FETCH-LOGICAL-c347t-e8c8e386e40ccef2d5f8ca7c36fb7de5630e15b426c07064337696ace6408ec33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17814484$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16738146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DIPIAZZA, Deann</creatorcontrib><creatorcontrib>RICHTER, Holly E</creatorcontrib><creatorcontrib>CHAPMAN, Victoria</creatorcontrib><creatorcontrib>CLIVER, Suzanne P</creatorcontrib><creatorcontrib>NEELY, Cherry</creatorcontrib><creatorcontrib>CHI CHIUNG CHEN</creatorcontrib><creatorcontrib>BURGIO, Kathryn L</creatorcontrib><title>Risk factors for anal sphincter tear in multiparas</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description>To assess maternal, newborn, and obstetric risk factors associated with anal sphincter tear in multiparous women.
This case-control study identified 18,779 multiparous vaginal deliveries from 1992 to 2004 from an obstetric automated record database at the University of Alabama at Birmingham. Two hundred eighty-four patients were selected, 145 cases and 139 controls. Variables from the index pregnancy and prior pregnancies were analyzed, and multivariable logistic regression models were constructed to determine significant predictor variables for anal sphincter tear in multiparous women.
One hundred forty-five multiparous women with no history of cesarean delivery sustained a sphincter tear. Multivariable logistic regression showed a significant association with episiotomy (odds ratio [OR] 16.3, 95% confidence interval [CI] 7.7-34.4), shoulder dystocia (OR 7.9, CI 1.6-38), forceps delivery (OR 4.7, CI 2.0-11.2), and being married (OR 2.2, CI 1.1-4.6). A second exploratory model that included variables from previous pregnancies, showed that in addition to episiotomy (OR 34.6, CI 8.8-136), shoulder dystocia (OR 11.1, CI 1.3-95.2), forceps delivery (OR 6.1, CI 1.6-23.5), previous sphincter tear (OR 7.7, CI 1.2-48.7), and second stage of labor greater than 1 hour (OR 6.7, CI 1.1-42.5) were associated with tear.
The strongest clinical risk factors for anal sphincter tear in multiparous women are episiotomy, shoulder dystocia, previous sphincter tear, prolonged second stage of labor, and forceps delivery.
II-2.</description><subject>Adult</subject><subject>Anal Canal - injuries</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Delivery, Obstetric - adverse effects</subject><subject>Delivery. Postpartum. Lactation</subject><subject>Episiotomy - statistics & numerical data</subject><subject>Extraction, Obstetrical - adverse effects</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Labor Stage, Second</subject><subject>Medical sciences</subject><subject>Parity</subject><subject>Pregnancy</subject><subject>Risk Factors</subject><subject>Time Factors</subject><issn>0029-7844</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1LAzEQhoMotlb_giyC3nZNdrJJ1lspWoVCQRS8hTSd4Op-mewe_PemttC5zGGed4Z5CLlhNGO0lPeUZfP1MqOxciZFKbK8KLjKnDshU6YkpDnAxymZxnmZSsX5hFyE8BV5Jko4JxMmJCjGxZTkr1X4TpyxQ-dD4jqfmNbUSeg_q9YO6JMBjU-qNmnGeqh64024JGfO1AGvDn1G3p8e3xbP6Wq9fFnMV6kFLocUlVUISiCn1qLLt4VT1kgLwm3kFgsBFFmx4bmwVFLBAXavGIuCU4UWYEbu9nt73_2MGAbdVMFiXZsWuzFooSgAozyCD3vQ-i4Ej073vmqM_9WM6p0xTZmOxvTRmP43pp2L4evDlXHT4PYYPSiKwO0BMMGa2nnT2iocORkprjj8ASMJdFs</recordid><startdate>20060601</startdate><enddate>20060601</enddate><creator>DIPIAZZA, Deann</creator><creator>RICHTER, Holly E</creator><creator>CHAPMAN, Victoria</creator><creator>CLIVER, Suzanne P</creator><creator>NEELY, Cherry</creator><creator>CHI CHIUNG CHEN</creator><creator>BURGIO, Kathryn L</creator><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20060601</creationdate><title>Risk factors for anal sphincter tear in multiparas</title><author>DIPIAZZA, Deann ; RICHTER, Holly E ; CHAPMAN, Victoria ; CLIVER, Suzanne P ; NEELY, Cherry ; CHI CHIUNG CHEN ; BURGIO, Kathryn L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-e8c8e386e40ccef2d5f8ca7c36fb7de5630e15b426c07064337696ace6408ec33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Anal Canal - injuries</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Delivery, Obstetric - adverse effects</topic><topic>Delivery. Postpartum. Lactation</topic><topic>Episiotomy - statistics & numerical data</topic><topic>Extraction, Obstetrical - adverse effects</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Labor Stage, Second</topic><topic>Medical sciences</topic><topic>Parity</topic><topic>Pregnancy</topic><topic>Risk Factors</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DIPIAZZA, Deann</creatorcontrib><creatorcontrib>RICHTER, Holly E</creatorcontrib><creatorcontrib>CHAPMAN, Victoria</creatorcontrib><creatorcontrib>CLIVER, Suzanne P</creatorcontrib><creatorcontrib>NEELY, Cherry</creatorcontrib><creatorcontrib>CHI CHIUNG CHEN</creatorcontrib><creatorcontrib>BURGIO, Kathryn L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DIPIAZZA, Deann</au><au>RICHTER, Holly E</au><au>CHAPMAN, Victoria</au><au>CLIVER, Suzanne P</au><au>NEELY, Cherry</au><au>CHI CHIUNG CHEN</au><au>BURGIO, Kathryn L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for anal sphincter tear in multiparas</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>2006-06-01</date><risdate>2006</risdate><volume>107</volume><issue>6</issue><spage>1233</spage><epage>1237</epage><pages>1233-1237</pages><issn>0029-7844</issn><eissn>1873-233X</eissn><coden>OBGNAS</coden><abstract>To assess maternal, newborn, and obstetric risk factors associated with anal sphincter tear in multiparous women.
This case-control study identified 18,779 multiparous vaginal deliveries from 1992 to 2004 from an obstetric automated record database at the University of Alabama at Birmingham. Two hundred eighty-four patients were selected, 145 cases and 139 controls. Variables from the index pregnancy and prior pregnancies were analyzed, and multivariable logistic regression models were constructed to determine significant predictor variables for anal sphincter tear in multiparous women.
One hundred forty-five multiparous women with no history of cesarean delivery sustained a sphincter tear. Multivariable logistic regression showed a significant association with episiotomy (odds ratio [OR] 16.3, 95% confidence interval [CI] 7.7-34.4), shoulder dystocia (OR 7.9, CI 1.6-38), forceps delivery (OR 4.7, CI 2.0-11.2), and being married (OR 2.2, CI 1.1-4.6). A second exploratory model that included variables from previous pregnancies, showed that in addition to episiotomy (OR 34.6, CI 8.8-136), shoulder dystocia (OR 11.1, CI 1.3-95.2), forceps delivery (OR 6.1, CI 1.6-23.5), previous sphincter tear (OR 7.7, CI 1.2-48.7), and second stage of labor greater than 1 hour (OR 6.7, CI 1.1-42.5) were associated with tear.
The strongest clinical risk factors for anal sphincter tear in multiparous women are episiotomy, shoulder dystocia, previous sphincter tear, prolonged second stage of labor, and forceps delivery.
II-2.</abstract><cop>New York, NY</cop><pub>Elsevier Science</pub><pmid>16738146</pmid><doi>10.1097/01.AOG.0000217696.25548.ff</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Anal Canal - injuries Biological and medical sciences Case-Control Studies Delivery, Obstetric - adverse effects Delivery. Postpartum. Lactation Episiotomy - statistics & numerical data Extraction, Obstetrical - adverse effects Female Gynecology. Andrology. Obstetrics Humans Labor Stage, Second Medical sciences Parity Pregnancy Risk Factors Time Factors |
| title | Risk factors for anal sphincter tear in multiparas |
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