title: Symphysiolysis as an independent risk factor for cesarean delivery.
abstract: OBJECTIVE
  To investigate whether symphysiolysis during pregnancy is a risk factor for cesarean delivery (CD).
  
  
  METHODS
  A retrospective population-based study comparing all singleton pregnancies of women with and without symphysiolysis was conducted. Deliveries occurred between the years 2000 and 2007. Multiple logistic regression models were used to control for confounders.
  
  
  RESULTS
  Out of 80,898 patients, 0.2% (n = 154) were diagnosed with symphysiolysis during pregnancy. Patients with symphysiolysis were significantly older as compared to the comparison group. These patients had higher rates of mild pre-eclampsia, gestational diabetes mellitus (GDM) and labor induction as compared to patients without symphysiolysis. Higher rates of CD were noted in pregnancies complicated by symphysiolysis [22.1% vs. 15.9%; Odds ratio (OR) = 1.5, 95% confidence interval (CI) 1.02-2.2; P = 0.036]. Using multiple logistic regression model, with symphysiolysis as the outcome variable, controlling for labor induction, mild pre-eclampsia and GDM, symphysiolysis was noted as an independent risk factor for CD (weighted OR = 1.7, 95% CI 1.1-2.5; P = 0.009). Perinatal outcomes such as low Apgar scores (<7) at 1 and 5 min and perinatal mortality were comparable between the groups.
  
  
  CONCLUSIONS
  Symphysiolysis is an independent risk factor for CD.
authors.affiliation: Department of Orthopedics, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er-Sheva, Israel.
authors.forename: David E
authors.initials: DE
authors.lastname: Lebel
authors.forename: Amalia
authors.initials: A
authors.lastname: Levy
authors.forename: Gershon
authors.initials: G
authors.lastname: Holcberg
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D017699:Pelvic Pain / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D011153:Population; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000473:pathology; D011256:Pregnancy Outcome; D011631:Pubic Symphysis / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult