The impact of third- or fourth-degree perineal tears on the second pregnancy: A cohort study of 182,445 Scottish women.

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  • Additional Information
    • Publication Year:
      2019
    • Subject Terms:
    • Author-Supplied Keywords:
      Birth
      Case-control studies
      Diabetes mellitus
      Endocrine disorders
      Endocrinology
      Epidemiology
      Europe
      European Union
      Geographical locations
      Gestational diabetes
      Labor and delivery
      Maternal health
      Medical risk factors
      Medicine and health sciences
      Metabolic disorders
      Obstetrics and gynecology
      People and places
      Pregnancy
      Research and analysis methods
      Research Article
      Research design
      Scotland
      United Kingdom
      Women's health
    • Subject Terms:
    • Abstract:
      This study aimed to investigate the reproductive impact of a third- or fourth-degree tear in primigravid women. A retrospective population-based cohort study was conducted using data from Scottish Morbidity Records (SMR02). Primigravid women with a vaginal birth in Scotland from 1997 until 2010 were included. Exposure was third- or fourth-degree tear in the first pregnancy. The second pregnancy rate, interpregnancy interval and third- or fourth-degree tear in a second pregnancy were the primary outcomes. A nested case-control study was used to determine factors associated with repeat third- or fourth-degree tears in a second vaginal birth. Cox regression analysis and logistic regression were used to look for associations. Initial third- or fourth-degree tear occurred in 2.8% women (5174/182445). The percentage of third- or fourth-degree tears in first vaginal births increased from 1% in 1997 to 4.9% in 2010. There was no difference in having a second pregnancy (adjusted Odds Ratio (aOR) 0.98 (99%CI 0.89–1.09)) or the median interpregnancy interval to second pregnancy (adjusted Hazard Ratio (aHR) 1.01 (99%CI 0.95–1.08)) after an initial third- or fourth-degree tear. Women were over four times more likely to have a repeat injury in a subsequent vaginal birth (n = 149/333, aOR 4.68 (99% 3.52–6.23)) and were significantly more likely to have an elective caesarean section in their second pregnancy (n = 887/3333, 26.6%; 12.75 (11.29–14.40)). Increased maternal age and birthweight ≥4500g were risk factors for repeat injury. Third- and fourth-degree tears are increasing in Scotland. Women do not delay or avoid childbirth after initial third- or fourth-degree tear. However, women are more likely to have a repeat third- or fourth-degree tear or an elective caesarean section in the second pregnancy. Strategies to prevent third- or fourth-degree tears are needed. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • ISSN:
      19326203
    • Accession Number:
      135836286
  • Citations
    • ABNT:
      WOOLNER, A. M. et al. The impact of third- or fourth-degree perineal tears on the second pregnancy: A cohort study of 182,445 Scottish women. PLoS ONE, [s. l.], v. 14, n. 4, p. 1, 2019. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=135836286. Acesso em: 6 jul. 2020.
    • AMA:
      Woolner AM, Ayansina D, Black M, Bhattacharya S. The impact of third- or fourth-degree perineal tears on the second pregnancy: A cohort study of 182,445 Scottish women. PLoS ONE. 2019;14(4):1. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=135836286. Accessed July 6, 2020.
    • AMA11:
      Woolner AM, Ayansina D, Black M, Bhattacharya S. The impact of third- or fourth-degree perineal tears on the second pregnancy: A cohort study of 182,445 Scottish women. PLoS ONE. 2019;14(4):1. Accessed July 6, 2020. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=135836286
    • APA:
      Woolner, A. M., Ayansina, D., Black, M., & Bhattacharya, S. (2019). The impact of third- or fourth-degree perineal tears on the second pregnancy: A cohort study of 182,445 Scottish women. PLoS ONE, 14(4), 1.
    • Chicago/Turabian: Author-Date:
      Woolner, Andrea Mary, Dolapo Ayansina, Mairead Black, and Sohinee Bhattacharya. 2019. “The Impact of Third- or Fourth-Degree Perineal Tears on the Second Pregnancy: A Cohort Study of 182,445 Scottish Women.” PLoS ONE 14 (4): 1. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=135836286.
    • Harvard:
      Woolner, A. M. et al. (2019) ‘The impact of third- or fourth-degree perineal tears on the second pregnancy: A cohort study of 182,445 Scottish women’, PLoS ONE, 14(4), p. 1. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=135836286 (Accessed: 6 July 2020).
    • Harvard: Australian:
      Woolner, AM, Ayansina, D, Black, M & Bhattacharya, S 2019, ‘The impact of third- or fourth-degree perineal tears on the second pregnancy: A cohort study of 182,445 Scottish women’, PLoS ONE, vol. 14, no. 4, p. 1, viewed 6 July 2020, .
    • MLA:
      Woolner, Andrea Mary, et al. “The Impact of Third- or Fourth-Degree Perineal Tears on the Second Pregnancy: A Cohort Study of 182,445 Scottish Women.” PLoS ONE, vol. 14, no. 4, Apr. 2019, p. 1. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=135836286.
    • Chicago/Turabian: Humanities:
      Woolner, Andrea Mary, Dolapo Ayansina, Mairead Black, and Sohinee Bhattacharya. “The Impact of Third- or Fourth-Degree Perineal Tears on the Second Pregnancy: A Cohort Study of 182,445 Scottish Women.” PLoS ONE 14, no. 4 (April 12, 2019): 1. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=135836286.
    • Vancouver/ICMJE:
      Woolner AM, Ayansina D, Black M, Bhattacharya S. The impact of third- or fourth-degree perineal tears on the second pregnancy: A cohort study of 182,445 Scottish women. PLoS ONE [Internet]. 2019 Apr 12 [cited 2020 Jul 6];14(4):1. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=135836286