Predictors of severe perineal lacerations in Chinese women

• Published in: Journal of perinatal medicine Vol. 37; no. 2; pp. 109 - 113
• Main Authors: Schwartz, Nadav, Seubert, David E., Mierlak, Julian, Arslan, Alan A.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Berlin Walter de Gruyter 01.03.2009; De Gruyter
• Subjects: Adult; Biological and medical sciences; Birth Weight; Body Mass Index; China - ethnology; Chinese; Cohort Studies; Delivery, Obstetric - methods; Delivery. Postpartum. Lactation; Female; Gestational Age; Gynecology. Andrology. Obstetrics; Hispanic Americans; Humans; Medical sciences; Obstetric Labor Complications - epidemiology; Obstetric Labor Complications - ethnology; Parity; Parturition; perineal laceration; perineal trauma; Perineum - injuries; Pregnancy; Retrospective Studies; vaginal delivery; Asia; China; Human; Laceration; Asiatic; Prediction; Neonatology; Perineum; Trauma; Body mass index; Vaginal route; perineal trauma; Adult; Chinese; Female; Delivery; Predictive factor; Woman; Severe; perineal laceration; vaginal delivery
• ISSN: 0300-5577; 1619-3997
• DOI: 10.1515/JPM.2009.035

Objective: Chinese women have been shown to have a higher incidence of severe perineal laceration compared to other ethnic groups. We sought to test the hypothesis that this risk is related to body mass index (BMI) or to a relative fetal-maternal size disproportion as measured by the ratio of the newborn birthweight to maternal BMI (BW:BMI). Methods: A retrospective cohort study was performed using a pre-existing obstetric database. Third- and fourth-degree perineal lacerations served as the primary outcome of interest. Logistic regression was used to compare Chinese women to other ethnic groups and adjust for confounders. Results: Three thousand and eighty-five singleton vaginal deliveries were identified, with BMI data available for 2281. Chinese women had a greater risk for severe perineal laceration compared to Caucasian (OR: 3.22; 95% CI: 0.73–14.32) and Hispanic women (OR: 2.88; 95% CI: 1.92–4.30). Multivariate analysis found that newborn birth weight plays a role (OR: 1.0012; 95% CI: 1.0007–1.0016), but BMI alone did not explain the discrepancy (P=0.89). However, the BW:BMI ratio appears to be a stronger predictor of laceration rate than either variable alone (OR: 1.011; 95% CI: 1.003–1.020). Conclusion: The higher risk of severe perineal laceration in Chinese women compared to other ethnicities can be attributed, in part, to a relative fetal-maternal size disproportion.