The Department of Gynecologic Oncology, Hadassah Medical Center, Jerusalem, Israel.
Faculty of Medicine, Hebrew University, Jerusalem, Israel.
Int J Gynaecol Obstet. 2024 May;165(2):801-805. doi: 10.1002/ijgo.15257. Epub 2023 Nov 27.
Data available at admission to delivery of nulliparous has rarely been investigated for prediction of obstetric anal sphincter injury (OASI). The aim of the present study was to study risk factors for OASI in nulliparous based on information available at admission.
A retrospective study of all nulliparous women undergoing labor, during March 2011 to January 2021 was performed. We compared women with OASI following delivery to those without by univariate and multivariable regression.
A total of 30 262 deliveries were included and 4181 (13.4%) of those were delivered by an emergent cesarean delivery. OASI followed 453 (1.5%) deliveries. Women in the OASI group were younger 29 ± 4.4 versus 30 ± 4.8, P = 0.001. In a multivariable regression analysis, higher sonographic estimated fetal weight was positively associated with OASI occurrence (aOR, 95% CI: 1.13 [1.00-1.29]). Maternal age was inversely associated with OASI occurrence (adjusted odds ratio [aOR], 95% confidence interval [CI] 0.95 [0.92-0.97]).
Sonographic fetal weight estimation is an independent risk factor for OASI occurrence that may be available at admission for delivery among nulliparous women.
分娩时的初产妇数据很少用于预测产科肛门括约肌损伤（OASI）。本研究旨在根据入院时的信息研究初产妇发生 OASI 的危险因素。
对 2011 年 3 月至 2021 年 1 月期间所有进行分娩的初产妇进行回顾性研究。我们通过单变量和多变量回归比较分娩后发生 OASI 的女性和未发生 OASI 的女性。
共纳入 30262 例分娩，其中 453 例（1.5%）为紧急剖宫产分娩。453 例（1.5%）分娩发生了 OASI。OASI 组的女性年龄较小，为 29±4.4 岁，而未发生 OASI 的女性为 30±4.8 岁，P=0.001。在多变量回归分析中，超声估计胎儿体重越高与 OASI 发生呈正相关（优势比，95%置信区间：1.13[1.00-1.29]）。产妇年龄与 OASI 发生呈负相关（调整后比值比[aOR]，95%置信区间[CI]0.95[0.92-0.97]）。
超声胎儿体重估计是 OASI 发生的独立危险因素，在初产妇分娩时可能已经可以获得。
