title: Is Asian ethnicity an independent risk factor for severe perineal trauma in childbirth? A systematic review of the literature.
abstract: OBJECTIVE
  To undertake a systematic review of the literature to determine whether Asian ethnicity is an independent risk factor for severe perineal trauma in childbirth.
  
  
  METHODS
  Ovid Medline, CINAHL, and Cochrane databases published in English were used to identify appropriate research articles from 2000 to 2010, using relevant terms in a variety of combinations. All articles included in this systematic review were assessed using the Critical Appraisal Skills Programme (CASP) 'making sense of evidence' tools.
  
  
  RESULTS
  Asian ethnicity does not appear to be a risk factor for severe perineal trauma for women living in Asia. In contrast, studies conducted in some Western countries have identified Asian ethnicity as a risk factor for severe perineal trauma. It is unknown why (in some situations) Asian women are more vulnerable to this birth complication. The lack of an international standard definition for the term Asian further undermines clarification of this issue. Nevertheless, there is an urgent need to explore why Asian women are reported to be significantly at risk for severe perineal trauma in some Western countries.
  
  
  CONCLUSIONS
  Current research on this topic is confusing and conflicting. Further research is urgently required to explore why Asian women are at risk for severe perineal trauma in some birth settings.
authors: Liverpool Hospital, Sydney South West Area Health Service, Elizabeth Street, Liverpool, NSW, 2170, Australia. janet_wheeler@bigpond.com
authors: Janet
authors: J
authors: Wheeler
authors: Deborah
authors: D
authors: Davis
authors: Margaret
authors: M
authors: Fry
authors: Pat
authors: P
authors: Brodie
authors: Caroline S E
authors: CS
authors: Homer
mesh_terms: D005260:Female; D006801:Humans; D011247:Pregnancy; D044466:Asian People; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods; D022125:Lacerations; D007744:Obstetric Labor Complications / Q000208:ethnology; D036801:Parturition; D010502:Perineum / Q000293:injuries; D012307:Risk Factors; D012720:Severity of Illness Index