Health Sciences University Tepecik Education and Research Hospital, Department of Obstetrics and Gynaecology, Izmir, Turkey; Ege University, Institute of Health Sciences, Department of Stem Cell, Izmir, Turkey.
Health Sciences University Tepecik Education and Research Hospital, Department of Obstetrics and Gynaecology, Izmir, Turkey.
J Pediatr Adolesc Gynecol. 2022 Jun;35(3):323-328. doi: 10.1016/j.jpag.2021.10.017. Epub 2021 Nov 5.
The incidence and risk factors of obstetric perineal tear occurrence in vaginal delivery of adolescent pregnant patients are not well established. We aimed to describe the incidence of obstetric perineal tears in adolescents and the maternal obstetric risk factors associated with this situation.
Retrospective cohort study SETTING: Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Izmir, Turkey PARTICIPANTS: Adolescent pregnant patients (≤19 years) who delivered vaginally in our institution between January 2014 and January 2021 INTERVENTIONS AND MAIN OUTCOME MEASURES: The main outcome measures were the incidence of perineal tears, the degree of perineal tears, and the risk factors associated with severe perineal tears in adolescents. Severe perineal tears include third- and fourth-degree lacerations. A third-degree tear is defined as partial or complete disruption of the anal sphincter muscles, and a fourth-degree tear is defined as lacerations involving the rectal mucosa.
A total of 3441 adolescents who had a vaginal delivery were included in the study. The rate of severe perineal tear was 5.8% (200/3441). Risk factors associated with obstetric laceration in adolescents in multivariate analysis were nulliparity (OR = 1.72; 95% CI, 1.14-2.41; P = 0.007), high birth weight (OR = 4.1; 95% CI, 2.71-6.21; P < 0.001), and labor induction (OR = 1.36; 95% CI, 1.01-1.85; P = 0.02). Spontaneous onset of labor and previous delivery reduced the risk of severe perineal tear in adolescent pregnant patients (respectively, OR = 0.68; 95% CI, 0.51-0.94; P = 0.02 and OR = 0.51; 95% CI, 0.33-0.79; P = 0.007).
In adolescents, the risk of severe perineal tear was associated with nulliparity, birth weight, and labor induction. The only possible modifiable risk factor was labor induction.
阴道分娩的青少年孕妇发生产科会阴撕裂的发生率和危险因素尚未明确。本研究旨在描述青少年产妇会阴撕裂的发生率，以及与这种情况相关的产妇产科危险因素。
回顾性队列研究
土耳其伊兹密尔 Tepecik 教育与研究医院妇产科
2014 年 1 月至 2021 年 1 月在我院阴道分娩的青少年孕妇（≤19 岁）
主要观察结果是会阴撕裂的发生率、会阴撕裂的程度，以及与青少年严重会阴撕裂相关的危险因素。严重会阴撕裂包括三度和四度撕裂。三度撕裂定义为部分或完全肛门括约肌断裂，四度撕裂定义为累及直肠黏膜的撕裂。
共有 3441 名青少年进行了阴道分娩，其中 5.8%（200/3441）发生严重会阴撕裂。多变量分析中，与青少年产科撕裂相关的危险因素是初产妇（比值比[OR]，1.72；95%置信区间[CI]，1.14-2.41；P=0.007）、高出生体重（OR，4.1；95%CI，2.71-6.21；P<0.001）和引产（OR，1.36；95%CI，1.01-1.85；P=0.02）。自然分娩和经产妇可降低青少年孕妇发生严重会阴撕裂的风险（分别为 OR，0.68；95%CI，0.51-0.94；P=0.02 和 OR，0.51；95%CI，0.33-0.79；P=0.007）。
在青少年中，严重会阴撕裂的风险与初产妇、出生体重和引产有关。唯一可能改变的危险因素是引产。
