Are Asian American women at higher risk of severe perineal lacerations?

Abstract

Objective: To evaluate whether Asian race is an independent risk factor for severe perineal lacerations. Methods: We performed a nationwide population-based retrospective cohort study examining the relationship between Asian race and severe perineal lacerations (third and fourth degree). The data were collected from the 2012 Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS). Characteristics of Asian American women were compared with those of non-Asian women. The primary outcome of interest was severe perineal lacerations. Multivariable logistic regression was used to refine the associations between Asian race and severe perineal lacerations while adjusting for confounding effects. Results were compared with previously published data using a pooled odds ratio. Results: 2,270,044 Women with singleton vaginal deliveries were identified, and 120,452 (5.3%) were Asian. After adjusting for confounders, Asian women were more likely to experience severe perineal lacerations than any other racial group (3.5% versus 6.3%, adjusted odds ratio [aOR] 1.50, 99% CI 1.29-1.74, p50.0001). Analysis of literature indicated that Asian American women are 74% more likely to experience severe perineal lacerations (aOR 1.74, 99% CI 1.72-1.76, p50.0001) than non-Asians. Conclusion: Asian race is an independent risk factor for severe perineal lacerations in the United States.

Use of Prophylactic Antibiotics in Third and Fourth Degree of Perineal Rupture

“…The higher the rupture grade, the longer the patient's sexual function returns to normal. 33,34 Effectiveness of Prophylactic Use Of Antibiotics In Third and Fourthdegree Perineal Rupture) The use of prophylactic antibiotics can be used in various medical indications. Especially in the perioperative period can reduce the rate of postoperative wound infection.…”

Reflections on the Asian American and Pacific Islander Experience

“…Although it has been demonstrated many times over that Asian mothers have a higher risk of severe obstetric hemorrhage, 13 intensive care unit admission, unplanned hysterectomy, uterine rupture, 14 third-degree lacerations, fourth-degree lacerations, and rectal sphincter injuries, 15 the etiology of this increased risk is poorly understood and sparsely mentioned in the literature. The invisibility of AAPI perinatal outcomes in conversations about equitable maternity care is yet another example of the erasure and minimization of our collective history.…”

Comparison of perineal outcomes in Chinese women adopting lateral positions and lithotomy positions during the passive and active phases of the second stage of labour: An observational study

“…Another Belgian retrospective study also indicated that childbirth in lateral positions could result in fewer spontaneous perineal tears and episiotomies when compared with childbirth in lithotomy positions (Inge et al, 2012). Since Asian ethnicity has been reported to be a risk factor for perineal trauma (Davies‐Tuck et al, 2015; Quist‐Nelson et al, 2017; Yeaton‐Massey et al, 2015), Chinese women may be more vulnerable to perineal trauma. However, the protective effects of lateral positions against perineum trauma among the Chinese population remain inconclusive.…”