title: Trends and risk factors for severe perineal trauma during childbirth in New South Wales between 2000 and 2008: a population-based data study.
abstract: OBJECTIVE
  To determine trends and risk factors for severe perineal trauma between 2000 and 2008.
  
  
  METHODS
  This was a population-based data study.
  
  
  METHODS
  New South Wales, Australia.
  
  
  METHODS
  510 006 women giving birth to a singleton baby during the period 2000-2008.
  
  
  METHODS
  Rates of severe perineal trauma between 2000 and 2008 and associated demographic, fetal, antenatal, labour and delivery events and factors.
  
  
  RESULTS
  There was an increase in the overall rate of severe perineal trauma from 2000 to 2008 from 1.4% to 1.9% (36% increase). Compared with women who were intact or had minor perineal trauma (first-degree tear, vaginal graze/tear), women who were primiparous (adjusted OR (AOR) 1.8 CI (1.65 to 1.95), were born in China or Vietnam (AOR 1.1 CI (1.09 to 1.23), gave birth in a private hospital (AOR 1.1 CI (1.03 to 1.20), had an instrumental birth (AOR 1.8 CI (1.65 to 1.95) and male baby (AOR 1.3 CI (1.27 to 1.34) all had a significantly higher risk of severe perineal trauma. Only giving birth to a male baby, adjusted for birth weight (AOR 1.5 CI (1.44 to 1.58), remained significant, when women with severe perineal trauma were compared with all other women not experiencing severe perineal trauma. This association increased over the study period.
  
  
  CONCLUSIONS
  To our knowledge, this is the first time that having a male baby has been found to exert such a strong independent risk for severe perineal trauma and the increasing significance of this in recent years needs further exploration.
authors.affiliation: School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Dahlen
authors.forename: Holly
authors.initials: H
authors.lastname: Priddis
authors.forename: Virginia
authors.initials: V
authors.lastname: Schmied
authors.forename: Anne
authors.initials: A
authors.lastname: Sneddon
authors.forename: Christine
authors.initials: C
authors.lastname: Kettle
authors.forename: Chris
authors.initials: C
authors.lastname: Brown
authors.forename: Charlene
authors.initials: C
authors.lastname: Thornton