Abstract
Objective
To identify risk factors for increasing severity of OASI and evaluate its possible
correlation with two known risk factors–birth weight (BW) and neonatal head circumference
(HC).
Methods
We performed a retrospective cohort study at a university affiliated hospital between
2003 and 2019. We compared five groups of patients – according to presence and degree
of perineal laceration – 3a, 3b, 3c and 4 and patients without OASI. Additionally,
four parameters were defined to assess their relation to the severity of OASI: (1)
BW ≥ 90th and HC < 90th percentiles; (2) BW < 90th and HC ≥ 90th percentile; (3) BW
and HC ≥ 90th percentile and (4) BW and HC < 90th percentiles.
Results
During the study period, 150,221 deliveries were evaluated. Parturients were allocated
according to OASI severity − 455 patients had a 3rd (3a, 3b or 3c) or 4th degree perineal
tear, while 110,966 patients had no OASI. Allocation to subgroups according to offspring
anthropomorphic measures showed that as fetal size parameters increased, the rate
of more severe tears increased, particularly in women delivering neonates with HC ≥ 90th
percentile.
Multinomial regression analysis was performed for each 3rd degree OASI subgroup. This
analysis demonstrated the odds for OASI gradually increase with tear severity for
BW ≥ 90th percentile and the combined BW and HC ≥ 90th percentile parameters, as compared
with neonates with HC and BW < 90th percentile.
Conclusions
Birth weight and head circumference above the 90th percentile are correlated with
increased degree of OASI severity.
Keywords
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Article info
Publication history
Published online: August 26, 2021
Accepted:
August 24,
2021
Received in revised form:
July 26,
2021
Received:
June 8,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
