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Birthweight difference between deliveries and the risk of obstetric anal sphincter injury in parous women

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Abstract

Introduction and hypothesis

While obstetric anal sphincter injury (OASI) is less frequent in parous compared to nulliparous women, it remains a major concern affecting quality of life of women worldwide. The aim of this study was to evaluate the association between birthweight (BW) difference between deliveries and risk of OASI in parous women.

Methods

We performed a retrospective case-control study including parous women with at least one previous vaginal delivery who were diagnosed with OASI. The control group consisted of parous women who did not have OASI during vaginal delivery. Controls were matched in a 1:2 ratio by year of birth, maternal age, and parity. Medical history, obstetric background, and current labor-related data were compared. Further univariate and multivariable analyses were performed, assessing for risk factors for OASI.

Results

One hundred eight parous women who had a diagnosis of OASI and a control group of 216 parturients who delivered without OASI were included in the final analysis. Differences between the current BW and the preceding and maximal previous BW were evaluated. There were significantly higher rates of women who had a larger neonate with > 500 g difference between the current and previous BW in the OASI group than in those with no OASI (28.7% vs. 12.30%, respectively; p < 0.001). Following a multivariable analysis for the dependent parameter of OASI, the following parameters were found to be independently associated with OASI outcome: previous operative vaginal delivery, BW ≥ 90th percentile, and current BW ≥ 500 g compared to previous maximal BW.

Conclusions

In parous women, neonatal BW increase between deliveries of > 500 g is associated with OASI.

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Author notes

  1. Henry H. Chill and Gilad Karavani contributed equally to this work.

Authors and Affiliations

  1. Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, Skokie, IL, USA

    Henry H. Chill & Joel Winer

  2. Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    Gilad Karavani, Michal Lipschuetz, Tzvika Shimonovitz & David Shveiky

  3. Hebrew University Medical School, Jerusalem, Israel

    Keren Yishai

  4. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    David Shveiky

Authors
  1. Henry H. Chill
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  2. Gilad Karavani
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  3. Michal Lipschuetz
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  4. Keren Yishai
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  5. Joel Winer
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  6. Tzvika Shimonovitz
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  7. David Shveiky
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Contributions

Chill: Project development, data collection, data analysis, manuscript writing and editing.

Karavani: Project development, data collection, data analysis, manuscript writing and editing.

Lipschuetz: Data collection, data analysis, manuscript editing.

Yishai: Data collection, data analysis.

Winer: Manuscript writing and editing.

Shimonovitz: Data analysis, manuscript editing.

Shveiky: Project development, data analysis, manuscript writing and editing.

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Correspondence to Henry H. Chill.

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Chill, H.H., Karavani, G., Lipschuetz, M. et al. Birthweight difference between deliveries and the risk of obstetric anal sphincter injury in parous women. Int Urogynecol J 33, 3401–3406 (2022). https://doi.org/10.1007/s00192-022-05207-4

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  • DOI: https://doi.org/10.1007/s00192-022-05207-4

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