Obstetric anal sphincter injury in the second birth after perineal wound complication in the first birth: A nationwide register cohort study

IF 4.7 1区医学 Q1 OBSTETRICS & GYNECOLOGY

Bjog-An International Journal of Obstetrics and Gynaecology Pub Date : 2024-04-16 DOI:10.1111/1471-0528.17830

Agnes Rygaard, Maria Jonsson, Anna-Karin Wikström, Sophia Brismar-Wendel, Susanne Hesselman

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引用次数: 0

Abstract

Objective

To investigate whether perineal wound complications in the first birth, alone or in conjunction with obstetric anal sphincter injury (OASI), is associated with an increased risk of OASI in the second birth.

Design

Nationwide population-based cohort study.

Setting

Sweden.

Population

Women (n = 411 317) with first and second singleton vaginal births in Sweden, 2001–2019.

Methods

Data on diagnostic codes and surgical procedures were retrieved from the Swedish Medical Birth Register and the Swedish Patient Register. A perineal wound complication was defined as wound infection, dehiscence or perineal haematoma within 2 months of childbirth.

Main outcome measures

Associations between wound complications in the first birth and OASI in the second birth were investigated with logistic regression and presented as adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs).

Results

In total, 2619 (0.6%) women had a wound complication in the first birth, and 5318 (1.3%) had an OASI in the second birth. Women with a wound complication but no OASI in the first birth had more than doubled odds of OASI in the second birth (aOR 2.73, 95% CI 2.11–3.53). Women with OASI and a wound complication in the first birth had almost tenfold odds (aOR 9.97, 95% CI 6.53–15.24) of recurrent OASI.

Conclusions

Perineal wound complication in the first birth increases the likelihood of OASI in a subsequent birth.

Abstract Image

查看原文本刊更多论文

第一次分娩会阴伤口并发症后第二次分娩时的产科肛门括约肌损伤：全国性登记队列研究

目的研究第一次分娩时会阴伤口并发症（单独或合并产科肛门括约肌损伤（OASI））是否与第二次分娩时OASI风险增加有关。方法从瑞典出生医学登记册和瑞典患者登记册中检索诊断代码和手术程序数据。会阴伤口并发症定义为分娩后2个月内的伤口感染、裂开或会阴血肿。主要结果测量采用逻辑回归法研究了第一次分娩时伤口并发症与第二次分娩时OASI之间的关联，并以调整后的几率比（aORs）和95%置信区间（95% CIs）表示。第一胎有伤口并发症但无 OASI 的产妇在第二胎发生 OASI 的几率是第一胎的两倍多（aOR 2.73，95% CI 2.11-3.53）。结论第一次分娩时会阴伤口并发症会增加第二次分娩时发生 OASI 的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bjog-An International Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

10.90

自引率

5.20%

发文量

345

审稿时长

3-6 weeks

期刊介绍： BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.