title: Risk factors for perineal lacerations in teen deliveries.
abstract: OBJECTIVE
  : Severe perineal lacerations have been associated with the development of fecal incontinence. This study was designed to identify risk factors for severe perineal lacerations in vaginal delivery in a teen population.
  
  
  METHODS
  : This was a retrospective database analysis of 534 teen term, singleton, cephalic vaginal deliveries. The primary outcome was the occurrence of a third- or fourth-degree laceration. Categorical and continuous variables were compared using the χ and Student t tests, respectively.
  
  
  RESULTS
  : Overall, 43 (8.1%) of our patients had third- or fourth-degree lacerations. In a multivariate regression model, the use of insulin in pregnancy, episiotomy, operative vaginal delivery, and increased infant birth weight all had an increased odds ratio for severe perineal laceration.
  
  
  CONCLUSIONS
  : Operative vaginal delivery, episiotomy, increased infant birth weight and gestational diabetes requiring insulin for glucose control all appear to increase the risk of severe perineal laceration at the time of vaginal delivery in a teenage population.
authors.affiliation: From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, The Ohio State University Medical Center, Columbus, OH.
authors.forename: Danielle
authors.initials: D
authors.lastname: Patterson
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Hundley