Obesity May Be Protective against Severe Perineal Lacerations.
Objective. To determine if there is an association between BMI and 3rd- or 4th-degree perineal lacerations in normal spontaneous and operative vaginal deliveries. Study Design. We performed a retrospective case control study using a large obstetric quality improvement database over a six-year period. Cases were identified as singleton gestations with third- and fourth-degree lacerations. Controls were obtained randomly from the database of patients without third- or fourth-degree lacerations in a 1 : 1 ratio. Univariate and multivariate logistic regression analyses were performed. Results. Of 32,607 deliveries, 22,011 (67.5%) charts with BMI documented were identified. Third- or fourth-degree lacerations occurred in 2.74% (n = 605) of patients. 37% (n = 223) were identified in operative vaginal deliveries. In the univariate analysis, obesity, older maternal age, non-Asian race, and birth weight <4000 g were all protective against 3rd- and 4th-degree lacerations. After controlling for age, race, mode of vaginal delivery, and birth weight, obesity remained significant. Conclusion. Being obese may protect against third- and fourth-degree lacerations independent of parity, race, birth weight, and mode of delivery.
Department of Obstetrics & Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
Diana
D
Garretto
Hospitals Insurance Company, Inc., New York, NY 10016, USA.
Brian B
BB
Lin
Hospitals Insurance Company, Inc., New York, NY 10016, USA.
Helen L
HL
Syn
Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461, USA.
Nancy
N
Judge
Bronx Lebanon Hospital, Bronx, NY 10457, USA.
Karen
K
Beckerman
Maimonides Medical Center, Brooklyn, NY 11219, USA.
Fouad
F
Atallah
Mount Sinai Beth Israel Hospital, New York, NY 10011, USA.
Arnold
A
Friedman
Mount Sinai Hospital, New York, NY 10029, USA.
Michael
M
Brodman
Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461, USA.
Peter S
PS
Bernstein
D000328:Adult; D016022:Case-Control Studies; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D022125:Lacerations / Q000517:prevention & control*; D009765:Obesity / Q000453:epidemiology*; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000517:prevention & control*; D016017:Odds Ratio; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011256:Pregnancy Outcome; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology