TY - JOUR
T1 - A case-control study of the relationship between a passive second stage of labor and obstetric anal sphincter injuries
AU - Gossett, Dana R.
AU - Deibel, Philip
AU - Lewicky-Gaupp, Christina
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Objective To estimate the relationship between a passive second stage of labor and obstetric anal sphincter injuries (OASIS). Methods A retrospective, case-control study was undertaken of women who delivered at a tertiary-care center in Chicago, IL, USA, between November 2005 and December 2012. Cases had sustained OASIS and were matched on the basis of parity with controls who had no OASIS. Data were obtained from an electronic repository and chart review. Participants with a passive second stage of labor lasting 60 minutes or more were deemed to have "labored down." A logistic regression model to predict OASIS was created. Results Overall, 1629 cases were compared with 1312 controls. OASIS were recorded among 1452 (57.8%) of 2510 women who did not labor down compared with 169 (40.0%) of 423 women who labored down (P < 0.001). However, in binary logistic regression, the addition of laboring down to the model only increased the predictive accuracy from 80.1% to 80.7%. Conclusion When known risk factors for OASIS are accounted for, the effect of laboring down on perineal outcome is negligible.
AB - Objective To estimate the relationship between a passive second stage of labor and obstetric anal sphincter injuries (OASIS). Methods A retrospective, case-control study was undertaken of women who delivered at a tertiary-care center in Chicago, IL, USA, between November 2005 and December 2012. Cases had sustained OASIS and were matched on the basis of parity with controls who had no OASIS. Data were obtained from an electronic repository and chart review. Participants with a passive second stage of labor lasting 60 minutes or more were deemed to have "labored down." A logistic regression model to predict OASIS was created. Results Overall, 1629 cases were compared with 1312 controls. OASIS were recorded among 1452 (57.8%) of 2510 women who did not labor down compared with 169 (40.0%) of 423 women who labored down (P < 0.001). However, in binary logistic regression, the addition of laboring down to the model only increased the predictive accuracy from 80.1% to 80.7%. Conclusion When known risk factors for OASIS are accounted for, the effect of laboring down on perineal outcome is negligible.
KW - Labor down
KW - Labor management
KW - Obstetric anal sphincter injury
KW - Obstetric trauma
KW - Perineal laceration
KW - Second stage of labor
UR - http://www.scopus.com/inward/record.url?scp=84959473074&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959473074&partnerID=8YFLogxK
U2 - 10.1016/j.ijgo.2015.07.015
DO - 10.1016/j.ijgo.2015.07.015
M3 - Article
C2 - 26584847
AN - SCOPUS:84959473074
SN - 0020-7292
VL - 132
SP - 188
EP - 190
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 2
ER -