title: Are Asian American women at higher risk of severe perineal lacerations?
abstract: OBJECTIVE
  To evaluate whether Asian race is an independent risk factor for severe perineal lacerations.
  
  
  METHODS
  We performed a nationwide population-based retrospective cohort study examining the relationship between Asian race and severe perineal lacerations (third and fourth degree). The data were collected from the 2012 Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS). Characteristics of Asian American women were compared with those of non-Asian women. The primary outcome of interest was severe perineal lacerations. Multivariable logistic regression was used to refine the associations between Asian race and severe perineal lacerations while adjusting for confounding effects. Results were compared with previously published data using a pooled odds ratio.
  
  
  RESULTS
  2,270,044 Women with singleton vaginal deliveries were identified, and 120,452 (5.3%) were Asian. After adjusting for confounders, Asian women were more likely to experience severe perineal lacerations than any other racial group (3.5% versus 6.3%, adjusted odds ratio [aOR] 1.50, 99% CI 1.29-1.74, p < 0.0001). Analysis of literature indicated that Asian American women are 74% more likely to experience severe perineal lacerations (aOR 1.74, 99% CI 1.72-1.76, p < 0.0001) than non-Asians.
  
  
  CONCLUSIONS
  Asian race is an independent risk factor for severe perineal lacerations in the United States.
authors.affiliation: a Department of Obstetrics and Gynecology , Sidney Kimmel College of Medicine, Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Johanna
authors.initials: J
authors.lastname: Quist-Nelson
authors.affiliation: a Department of Obstetrics and Gynecology , Sidney Kimmel College of Medicine, Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Meiling
authors.initials: M
authors.lastname: Hua Parker
authors.affiliation: a Department of Obstetrics and Gynecology , Sidney Kimmel College of Medicine, Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
authors.affiliation: a Department of Obstetrics and Gynecology , Sidney Kimmel College of Medicine, Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: J
authors.initials: J
authors.lastname: Biba Nijjar
mesh_terms: D000328:Adult; D001213:Asian; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D022125:Lacerations / Q000453:epidemiology / Q000208:ethnology*; D016015:Logistic Models; D007744:Obstetric Labor Complications / Q000453:epidemiology; D016017:Odds Ratio; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Asian; Asian American; perineum; severe perineal laceration; vaginal delivery