Racial/ethnic differences in perineal, vaginal and cervical lacerations.
OBJECTIVE
To determine if variation exists between ethnicities for risk of perineal, vaginal, and cervical laceration at vaginal delivery.


METHODS
Retrospective cohort study of nulliparous women who underwent vaginal delivery of a vertex presentation. Predictor variable was ethnicity with outcome variables cervical, vaginal, and second-, third-, or fourth-degree perineal laceration. Logistic regression analysis was conducted to control for confounders.


RESULTS
Of the 17,216 who met criteria, Filipino (OR = 1.92, 95% CI 1.64-2.25) and Chinese (OR = 1.60, 95% CI 1.33-1.92) women were at greatest risk for third- and fourth-degree laceration. Only Filipino (OR = 1.32, 95% CI 1.10-1.57) and other Asian (OR = 1.23, 95% CI 1.08-1.41) women were at slightly increased risk of vaginal laceration. No differences were seen for cervical laceration.


CONCLUSIONS
Different ethnicities are at widely varying risk of perineal laceration, but little difference exists for vaginal or cervical lacerations. Research into the mechanisms behind this should investigate differences in perineal anatomy.
Hopkins
Linda M
LM
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA. hopkinsl@obgyn.ucsf.edu
Caughey
Aaron B
AB
Glidden
David V
DV
Laros
Russell K
RK
D002584:Cervix Uteri / Q000293:injuries*; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D006801:Humans; D022125:Lacerations; D016015:Logistic Models; D015999:Multivariate Analysis; D007744:Obstetric Labor Complications / Q000208:ethnology*; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D012189:Retrospective Studies; D014621:Vagina / Q000293:injuries*; D014947:Wounds and Injuries / Q000208:ethnology*