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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica


IMPACT FACTOR 2018: 1.361
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0300-5577
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Volume 37, Issue 2

Issues

Predictors of severe perineal lacerations in Chinese women

Nadav Schwartz
  • 1Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA and Gouverneur Healthcare Services, NYC Health and Hospitals Corporation, New York, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ David E. Seubert
  • 2Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA and Gouverneur Healthcare Services, NYC Health and Hospitals Corporation, New York, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Julian Mierlak
  • 3Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA and Gouverneur Healthcare Services, NYC Health and Hospitals Corporation, New York, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Alan A. Arslan
  • 4Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2009-01-15 | DOI: https://doi.org/10.1515/JPM.2009.035

Abstract

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.

Keywords: Body mass index; Chinese; perineal laceration; perineal trauma; vaginal delivery

About the article

Corresponding author: Nadav Schwartz, MD 462 First Ave, NB-9E2 New York, NY 10016 USA Tel.: +1 (212) 263-0223 Fax: +1 (212) 263-8887


Published Online: 2009-01-15

Published Online: 2009-01-16

Published in Print: 2009-03-01


Citation Information: Journal of Perinatal Medicine, Volume 37, Issue 2, Pages 109–113, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2009.035.

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