干旱区生态环境知识资源中心(Arid): Obstetric anal sphincter injuries among women with gestational diabetes and women without gestational diabetes: A NSW population-based cohort study

Arid

DOI	10.1111/ajo.12950
	Obstetric anal sphincter injuries among women with gestational diabetes and women without gestational diabetes: A NSW population-based cohort study
	Zeki, Reem 1; Li, Zhuoyang 1; Wang, Alex Y.1; Homer, Caroline S. E.2; Oats, Jeremy J. N.3; Marshall, Drew 4; Sullivan, Elizabeth A.1
通讯作者	Sullivan, Elizabeth A.
来源期刊	AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY
ISSN	0004-8666
EISSN	1479-828X
出版年	2019
卷号	59 期号:5 页码:662-669
英文摘要	Background Obstetric anal sphincter injuries (OASIs) are associated with maternal morbidity; however, it is uncertain whether gestational diabetes (GDM) is an independent risk factor when considering birthweight mode of birth and episiotomy. Aims To compare rates of OASIs between women with GDM and women without GDM by mode of birth and birthweight. To investigate the association between episiotomy, mode of birth and the risk of OASIs. Methods A population-based cohort study of women who gave birth vaginally in NSW, from 2007 to 2013. Rates of OASIs were compared between women with and without GDM, stratified by mode of birth, birthweight and a multi-categorical variable of mode of birth and episiotomy. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated by multivariable logistic regression. Results The rate of OASIs was 3.6% (95% CI: 2.6-2.7) vs 2.6% (95% CI: 3.4-2.8; P < 0.001) among women with and without GDM, respectively. Women with GDM and a macrosomic baby (birthweight >= 4000 g) had a higher risk of OASIs with forceps (aOR 1.76, 95% CI: 1.08-2.86, P = 0.02) or vacuum (aOR 1.89, 95% CI: 1.17-3.04, P = 0.01), compared with those without GDM. For primiparous women with GDM and all women without GDM, an episiotomy with forceps was associated with lower odds of OASIs than forceps only (primiparous GDM, forceps-episiotomy aOR 2.49, 95% CI: 2.00-3.11, forceps aOR 5.30, 95% CI: 3.72-7.54), (primiparous without GDM, forceps-episiotomy aOR 2.71, 95% CI: 2.55-2.89, forceps aOR 5.95, 95% CI: 5.41-6.55) and (multiparous without GDM, forceps-episiotomy aOR 3.75, 95% CI: 3.12-4.50, forceps aOR 6.20, 95% CI: 4.96-7.74). Conclusion Women with GDM and a macrosomic baby should be counselled about the increased risk of OASIs with both vacuum and forceps. With forceps birth, this risk can be partially mitigated by performing a concomitant episiotomy.
英文关键词	birth birthweight episiotomy gestational diabetes lacerations obstetric anal sphincter injury perineal trauma perineum
类型	Article
语种	英语
国家	Australia
开放获取类型	Green Accepted
收录类别	SCI-E
WOS记录号	WOS:000491447900009
WOS关键词	RISK-FACTORS ; TRENDS ; MELLITUS
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
EI主题词	2019-10-01
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/310087
作者单位	1.Univ Technol Sydney, Fac Hlth, Australian Ctr Publ & Populat Hlth Res, Sydney, NSW, Australia; 2.Univ Technol Sydney, Fac Hlth, Ctr Midwifery Child & Family Hlth, Sydney, NSW, Australia; 3.Univ Melbourne, Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia; 4.Westmead Hosp, Sydney, NSW, Australia
推荐引用方式 GB/T 7714	Zeki, Reem,Li, Zhuoyang,Wang, Alex Y.,et al. Obstetric anal sphincter injuries among women with gestational diabetes and women without gestational diabetes: A NSW population-based cohort study[J],2019,59(5):662-669.
APA	Zeki, Reem.,Li, Zhuoyang.,Wang, Alex Y..,Homer, Caroline S. E..,Oats, Jeremy J. N..,...&Sullivan, Elizabeth A..(2019).Obstetric anal sphincter injuries among women with gestational diabetes and women without gestational diabetes: A NSW population-based cohort study.AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY,59(5),662-669.
MLA	Zeki, Reem,et al."Obstetric anal sphincter injuries among women with gestational diabetes and women without gestational diabetes: A NSW population-based cohort study".AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY 59.5(2019):662-669.