干旱区生态环境知识资源中心(Arid): Temporal trends in the incidence of and associations between the risk factors for obstetrical anal sphincter injuries

Arid

DOI	10.1016/j.ajogmf.2020.100247
	Temporal trends in the incidence of and associations between the risk factors for obstetrical anal sphincter injuries
	Ekstein-Badichi, Naava; Shoham-Vardi, Ilana; Weintraub, Adi Y.
通讯作者	Ekstein-Badichi, N (corresponding author), Ben Gurion Univ Negev, Soroka Univ Med Ctr, Fac Hlth Sci, Dept Publ Hlth, Beer Sheva, Israel.
来源期刊	AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM
ISSN	2589-9333
出版年	2021
卷号	3 期号:1
英文摘要	BACKGROUND: Obstetrical anal sphincter injuries are an important complication of vaginal deliveries that may result in short- and long-term pelvic floor morbidity and a diminished quality of life in young, healthy women. The prevalence of obstetrical anal sphincter injuries ranges from 0.1% to 8.7%. Over recent years, there seems to be a trend of increasing occurrence of obstetrical anal sphincter injuries worldwide. It is unclear why the rates are rising. Previous studies have examined the effect of different risk factors on the prevalence of obstetrical anal sphincter injuries. The change in the incidence of some risk factors for obstetrical anal sphincter injuries can partially explain the overall increase in obstetrical anal sphincter injuries. There is no previous study that explored the impact of the changes of individual risk factors over time on the risk for obstetrical anal sphincter injuries. OBJECTIVE: The main aim of this study was to examine the temporal trends in the prevalence and odds ratio of the major risk factors known to be associated with obstetrical anal sphincter injuries in the period from 1988 to 2016. STUDY DESIGN: This was a retrospective cohort study that included all women who underwent vaginal deliveries between 1988 and 2016 at a tertiary university medical center. The time intervals were divided into 4 periods (1988-1997, 1998-2007, 2008-2016, and the total time from 1988 to 2016) and the incidence of each risk factor was calculated for each time period. Correlation models and regression analysis were performed to examine the association between obstetrical anal sphincter injuries and the different risk factors over time. Furthermore, the trends in the odds ratios of the important risk factors over the time periods were evaluated using a multivariate regression analysis in which the primiparous women were separated from the multiparous women. RESULTS: During the study period, there were 295,668 vaginal deliveries. Of these, 591 women were diagnosed with obstetrical anal sphincter injuries (0.2%). The significant risk factors for obstetrical anal sphincter injuries (P<.05) in the multivariable analysis were the following: primiparity, vaginal birth after cesarean delivery, vacuum extraction, and a birthweight of >4 kg. There was a significant (P<.05) increase in the incidence over the study period for the following risk factors: primiparity, vaginal birth after cesarean delivery, and vacuum extraction. No change was found in the incidence of the risk factor of a birthweight of >4 kg. In addition, we found a strengthening of the association between vaginal birth after cesarean delivery and macrosomia with obstetrical anal sphincter injuries, as opposed to a decline in the relative contribution of vacuum extraction to the overall risk for obstetrical anal sphincter injuries. Moreover, we found that obstetrical anal sphincter injuries among primiparous women increased 7-fold over the study period but was unchanged among multiparous women. CONCLUSION: We have shown significant (P<.05) temporal trends in the incidence and odds ratio of some of the known risk factors for obstetrical anal sphincter injuries. A better understanding of the changes in the incidence and specific contribution of important risk factors for obstetrical anal sphincter injuries may explain, in part, the worldwide increase in the prevalence of this important and detrimental complication of vaginal birth.
英文关键词	macrosomia OASIS primiparity trends over time vacuum extraction vaginal birth after cesarean
类型	Article
语种	英语
开放获取类型	Bronze
收录类别	ESCI
WOS记录号	WOS:000658262700004
WOS关键词	SEVERE PERINEAL TEARS ; FECAL INCONTINENCE ; VAGINAL BIRTH ; DELIVERY ; RECURRENCE ; ANALGESIA ; COUNTRIES ; IMPACT ; RATES ; LABOR
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
来源机构	Ben-Gurion University of the Negev
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/352728
作者单位	[Ekstein-Badichi, Naava; Shoham-Vardi, Ilana; Weintraub, Adi Y.] Ben Gurion Univ Negev, Soroka Univ Med Ctr, Fac Hlth Sci, Dept Publ Hlth, Beer Sheva, Israel; [Weintraub, Adi Y.] Ben Gurion Univ Negev, Soroka Univ Med Ctr, Dept Obstet & Gynecol, Beer Sheva, Israel
推荐引用方式 GB/T 7714	Ekstein-Badichi, Naava,Shoham-Vardi, Ilana,Weintraub, Adi Y.. Temporal trends in the incidence of and associations between the risk factors for obstetrical anal sphincter injuries[J]. Ben-Gurion University of the Negev,2021,3(1).
APA	Ekstein-Badichi, Naava,Shoham-Vardi, Ilana,&Weintraub, Adi Y..(2021).Temporal trends in the incidence of and associations between the risk factors for obstetrical anal sphincter injuries.AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM,3(1).
MLA	Ekstein-Badichi, Naava,et al."Temporal trends in the incidence of and associations between the risk factors for obstetrical anal sphincter injuries".AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM 3.1(2021).