title: Vaginismus as an independent risk factor for cesarean delivery.
abstract: OBJECTIVE
  The present study was aimed to investigate pregnancy outcome of patients with vaginismus, and specifically the relationship between vaginismus and cesarean delivery.
  
  
  METHODS
  A population based study comparing all pregnancies in patients with and without vaginismus was conducted. Patients lacking prenatal care were excluded from the analysis. Deliveries occurred during the years 1988-2007. A multivariate logistic regression model, with backward elimination, was constructed to find independent risk factors associated with vaginismus.
  
  
  RESULTS
  During the study period there were 192,954 deliveries, of which 118 occurred in patients with vaginismus. Patients with vaginismus tended to be younger (26.04+/-4.89 vs. 28.61+/-5.83; p < 0.001) and delivered smaller children (3024.2+/-517 g vs. 3160.9+/-576 g; p = 0.01) when compared with patients without vaginismus. Patients with vaginismus had higher rates of infertility treatments (5.9%vs. 2.7%, odds ratio [OR] 2.3; 95% confidence interval [CI] 1.1-4.9; p = 0.04) and labor induction (37.3%vs. 27.4%, OR 1.6; 95% CI 1.1-2.3; p = 0.02), vacuum extraction (9.3%vs. 2.8%, OR 3.6, 95% CI 1.9-6.7; p < 0.001), and cesarean delivery (39.0%vs. 14.5%, OR 3.8; 95% CI 2.6-5.5; p < 0.001) when compared with the comparison group. Even after controlling for possible confounders associated with cesarean delivery such as previous cesarean delivery, pathological presentations, and fetal distress, vaginismus remained as an independent risk factor for cesarean delivery (OR 7.1; 95% CI 4.5-11.1; p < 0.001).
  
  
  CONCLUSIONS
  Vaginismus is an independent risk factor for cesarean delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Be'er-Sheva, Israel.
authors.forename: Tomer
authors.initials: T
authors.lastname: Goldsmith
authors.forename: Amalia
authors.initials: A
authors.lastname: Levy
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
authors.forename: Tomer
authors.initials: T
authors.lastname: Goldsmith
authors.forename: Amalia
authors.initials: A
authors.lastname: Levy
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000601:surgery; D011256:Pregnancy Outcome; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D012307:Risk Factors; D052065:Vaginismus / Q000150:complications*; D055815:Young Adult