The impact of pre-pregnancy underweight on the risk of perineal and anal sphincter injury in nulliparous women.

IF 2.7 3区医学 Q2 OBSTETRICS & GYNECOLOGY

International Journal of Gynecology & Obstetrics Pub Date : 2026-10-26 DOI:10.1002/ijgo.71399

Daniel Gabbai, Omri Dominsky, Emmanuel Attali, Itamar Gilboa, Ronen Gold, Asnat Groutz, Yariv Yogev, Yoav Baruch

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Abstract

Introduction: Perineal injury is a common complication of vaginal delivery with maternal consequences. Although the effects of obesity are established, the impact of underweight on perineal and obstetric anal sphincter injury (OASI), remains unclear.

Objective: Our objective was to determine the association between pre-pregnancy underweight and the risk of non-severe perineal injury (NSPI) and OASI in nulliparous women.

Methods: A retrospective cohort study was conducted at a single, tertiary medical center including nulliparous women aged 18-45 years with singleton term vaginal deliveries (≥37 weeks) and pre-pregnancy body mass index (BMI) <25 kg/m² between 2012 and 2024. Women with diabetes were excluded. The cohort was divided into underweight (BMI <18.5 kg/m²) and normal BMI groups. The primary outcome was NSPI, and the secondary outcome was OASI. Multivariable logistic regression was performed to assess independent associations.

Results: Overall, 32 112 women were included, 12.9% of whom were underweight. Underweight women had lower birthweights and lower rates of induction and occiput-posterior presentation (all P < 0.05). NSPI occurred slightly less frequently among underweight women than among women with normal BMI (81.5% vs 84.3%, P < 0.001), whereas OASI was more common (1.1% vs 0.8%, P = 0.033). In the fully adjusted model, underweight BMI was associated with slightly lower odds of NSPI (adjusted odds ratio [aOR] 0.905; 95% confidence interval [CI] 0.825-0.994) and higher odds of OASI (aOR 1.641; 95% CI 1.179-2.286). Additional factors associated with OASI in the fully adjusted model included higher birthweight per 100 g increment (aOR 1.132; 95% CI 1.096-1.169), occiput-posterior presentation (aOR 2.815; 95% CI 1.806-4.386), prolonged second stage (aOR 1.590; 95% CI 1.158-2.182), and vacuum-assisted delivery (aOR 2.304; 95% CI 1.666-3.187).

Conclusion: Pre-pregnancy underweight was associated with slightly lower odds of NSPI but higher odds of OASI.

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孕前体重过轻对未产妇女会阴和肛门括约肌损伤风险的影响。

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

International Journal of Gynecology & Obstetrics 医学-妇产科学

CiteScore

5.80

自引率

2.60%

发文量

493

审稿时长

3-6 weeks

期刊介绍： The International Journal of Gynecology & Obstetrics publishes articles on all aspects of basic and clinical research in the fields of obstetrics and gynecology and related subjects, with emphasis on matters of worldwide interest.