title: Sphincter tears in primiparous women: is age a factor?
abstract: Anal sphincter tears during vaginal delivery may result in serious sequelae. We examined whether younger primiparous patients were at increased risk for sphincter tears during vaginal delivery. Data from an obstetric automated record were analyzed. Primiparous women delivering term infants (n = 5,937) were included to test for an association between age and sphincter tear rates. Three age groups were considered: young adolescents (≤ 16 years), older adolescents (17-20 years), and adults (≥ 21 years). No significant difference was found in tear rates among age cohorts (9.2%, 8.0%, and 9.6% respectively; p = 0.12). Logistic regression modeling revealed that young adolescents were not more likely to have sphincter tears compared to older cohorts. Younger adolescents may not be at increased risk of anal sphincter tears. Decisions regarding interventions to decrease sphincter tears during vaginal delivery should not be made on the basis of maternal age alone.
authors.affiliation: Division of Women's Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA. cbbowlingmd@gmail.com
authors.forename: C Bryce
authors.initials: CB
authors.lastname: Bowling
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Wheeler Ii
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Gerten
authors.forename: Victoria R
authors.initials: VR
authors.lastname: Chapman
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Burgio
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D001724:Birth Weight; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004841:Episiotomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D022125:Lacerations / Q000209:etiology*; D016015:Logistic Models; D008423:Maternal Age; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects; D055815:Young Adult