Bowling C Bryce, Wheeler Ii Thomas L, Gerten Kimberly A, Chapman Victoria R, Burgio Kathryn L, Richter Holly E
Division of Women's Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2009 May;20(5):565-9. doi: 10.1007/s00192-008-0754-0. Epub 2008 Nov 5.
Anal sphincter tears during vaginal delivery may result in serious sequelae. We examined whether younger primiparous patients were at increased risk for sphincter tears during vaginal delivery. Data from an obstetric automated record were analyzed. Primiparous women delivering term infants (n = 5,937) were included to test for an association between age and sphincter tear rates. Three age groups were considered: young adolescents (≤ 16 years), older adolescents (17-20 years), and adults (≥ 21 years). No significant difference was found in tear rates among age cohorts (9.2%, 8.0%, and 9.6% respectively; p = 0.12). Logistic regression modeling revealed that young adolescents were not more likely to have sphincter tears compared to older cohorts. Younger adolescents may not be at increased risk of anal sphincter tears. Decisions regarding interventions to decrease sphincter tears during vaginal delivery should not be made on the basis of maternal age alone.
阴道分娩时肛门括约肌撕裂可能会导致严重的后遗症。我们研究了年轻初产妇在阴道分娩时发生括约肌撕裂的风险是否增加。分析了产科自动记录中的数据。纳入分娩足月婴儿的初产妇（n = 5937），以测试年龄与括约肌撕裂率之间的关联。考虑了三个年龄组：年轻青少年（≤16岁）、年长青少年（17 - 20岁）和成年人（≥21岁）。各年龄组的撕裂率无显著差异（分别为9.2%、8.0%和9.6%；p = 0.12）。逻辑回归模型显示，与年长组相比，年轻青少年发生括约肌撕裂的可能性并不更高。较年轻的青少年发生肛门括约肌撕裂的风险可能不会增加。不应仅根据产妇年龄来决定降低阴道分娩时括约肌撕裂的干预措施。
