Obesity May Be Protective against Severe Perineal Lacerations

Abstract EN

Objective.

To determine if there is an association between BMI and 3rd- or 4th-degree perineal lacerations in normal spontaneous and operative vaginal deliveries.

Study Design.

We performed a retrospective case control study using a large obstetric quality improvement database over a six-year period.

Cases were identified as singleton gestations with third- and fourth-degree lacerations.

Controls were obtained randomly from the database of patients without third- or fourth-degree lacerations in a 1 : 1 ratio.

Univariate and multivariate logistic regression analyses were performed.

Results.

Of 32,607 deliveries, 22,011 (67.5%) charts with BMI documented were identified.

Third- or fourth-degree lacerations occurred in 2.74% (n=605) of patients.

37% (n=223) were identified in operative vaginal deliveries.

In the univariate analysis, obesity, older maternal age, non-Asian race, and birth weight <4000 g were all protective against 3rd- and 4th-degree lacerations.

After controlling for age, race, mode of vaginal delivery, and birth weight, obesity remained significant.

Conclusion.

Being obese may protect against third- and fourth-degree lacerations independent of parity, race, birth weight, and mode of delivery.