Obesity May Be Protective against Severe Perineal Lacerations

Journal of Obesity - Tập 2016 - Trang 1-5 - 2016
Diana Garretto1, Brian B. Lin2, Helen L. Syn2, Nancy E. Judge3, Karen Beckerman4, Fouad Atallah5, Arnold J. Friedman6, Michael Brodman7, Peter S. Bernstein3
1Department of Obstetrics & Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY 11794, USA
2Hospitals Insurance Company, Inc., New York, NY 10016, USA
3Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461, USA
4Bronx Lebanon Hospital, Bronx, NY 10457, USA
5Maimonides Medical Center, Brooklyn, NY 11219, USA
6Mount Sinai Beth Israel Hospital, New York, NY 10011, USA
7Mount Sinai Hospital, New York, NY, 10029, USA

Tóm tắt

Objective.To determine if there is an association between BMI and 3rd- or 4th-degree perineal lacerations in normal spontaneous and operative vaginal deliveries.Study Design.We performed a retrospective case control study using a large obstetric quality improvement database over a six-year period. Cases were identified as singleton gestations with third- and fourth-degree lacerations. Controls were obtained randomly from the database of patients without third- or fourth-degree lacerations in a 1 : 1 ratio. Univariate and multivariate logistic regression analyses were performed.Results.Of 32,607 deliveries, 22,011 (67.5%) charts with BMI documented were identified. Third- or fourth-degree lacerations occurred in 2.74% (n=605) of patients. 37% (n=223) were identified in operative vaginal deliveries. In the univariate analysis, obesity, older maternal age, non-Asian race, and birth weight <4000 g were all protective against 3rd- and 4th-degree lacerations. After controlling for age, race, mode of vaginal delivery, and birth weight, obesity remained significant.Conclusion.Being obese may protect against third- and fourth-degree lacerations independent of parity, race, birth weight, and mode of delivery.

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