{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:28:25Z","timestamp":1793053705952,"version":"4.5.0"},"reference-count":61,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","ejog.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Obstetrics & Gynecology and Reproductive Biology"],"published-print":{"date-parts":[[2020,4]]},"DOI":"10.1016\/j.ejogrb.2020.02.025","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T02:23:18Z","timestamp":1581646998000},"page":"94-100","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":127,"special_numbering":"C","title":["Risk factors for severe perineal trauma during childbirth: An updated meta-analysis"],"prefix":"10.1016","volume":"247","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4510-1633","authenticated-orcid":false,"given":"Vasilios","family":"Pergialiotis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5088-5458","authenticated-orcid":false,"given":"Ioannis","family":"Bellos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Fanaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9067-5308","authenticated-orcid":false,"given":"Nikolaos","family":"Vrachnis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0404-6335","authenticated-orcid":false,"given":"Stergios K.","family":"Doumouchtsis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ejogrb.2020.02.025_bib0005","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1016\/S0140-6736(18)32394-8","article-title":"Stemming the global caesarean section epidemic","volume":"392","author":"The","year":"2018","journal-title":"Lancet"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0010","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/1471-0528.13526","article-title":"WHO statement on caesarean section rates","volume":"123","author":"Betran","year":"2016","journal-title":"Bjog Int J Obstet Gynaecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0015","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1016\/S0140-6736(18)32113-5","article-title":"FIGO position paper: how to stop the caesarean section epidemic","volume":"392","author":"Visser","year":"2018","journal-title":"Lancet"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0020","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/AOG.0000000000001523","article-title":"Practice bulletin No. 165: prevention and management of obstetric lacerations at vaginal delivery","volume":"128","year":"2016","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0025","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1111\/birt.12258","article-title":"The effect of perineal lacerations on pelvic floor function and anatomy at 6 months postpartum in a prospective cohort of nulliparous women","volume":"43","author":"Leeman","year":"2016","journal-title":"Birth (Berkeley, Calif)"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0030","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1097\/OGX.0000000000000622","article-title":"Obstetric anal sphincter injuries at vaginal delivery: a review of recently published national guidelines","volume":"73","author":"Tsakiridis","year":"2018","journal-title":"Obstet Gynecol Surv"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0035","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.ijgo.2013.09.034","article-title":"Risk factors for severe perineal lacerations during childbirth","volume":"125","author":"Pergialiotis","year":"2014","journal-title":"Int J Gynaecol Obstet"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0040","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jclinepi.2009.06.006","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration","volume":"62","author":"Liberati","year":"2009","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0045","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1007\/s00192-018-3753-9","article-title":"Obstetric anal sphincter injury: a systematic review of information available on the internet","volume":"30","author":"Ghai","year":"2019","journal-title":"Int Urogynecol J"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0050","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/S0002-9378(99)70669-1","article-title":"Epidural analgesia in association with duration of labor and mode of delivery: a quantitative review","volume":"180","author":"Zhang","year":"1999","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0055","series-title":"The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis","author":"Wells","year":"2011"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0060","series-title":"Systematic reviews in health care","first-page":"157","article-title":"Why and how sources of heterogeneity should be investigated","author":"Egger","year":"2001"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0065","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1590\/1677-553820133806717","article-title":"Immunotherapy with Sipuleucel-T (APC8015) in patients with metastatic castration-refractory prostate cancer (mCRPC): a systematic review and meta-analysis","volume":"38","author":"Botrel","year":"2012","journal-title":"Int Braz J Urol"},{"issue":"5","key":"10.1016\/j.ejogrb.2020.02.025_bib0070","doi-asserted-by":"crossref","DOI":"10.18637\/jss.v049.i05","article-title":"Closing the gap between methodologists and end-users: R as a computational back-end","volume":"1","author":"Wallace","year":"2012","journal-title":"J Stat Softw"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0075","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-010247","article-title":"Plea for routinely presenting prediction intervals in meta-analysis","volume":"6","author":"IntHout","year":"2016","journal-title":"BMJ Open"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0080","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1111\/j.1471-0528.1994.tb13582.x","article-title":"Episiotomies and the occurrence of severe perineal lacerations","volume":"101","author":"Anthony","year":"1994","journal-title":"Br J Obstet Gynaecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0085","first-page":"797","article-title":"Association between median episiotomy and severe perineal lacerations in primiparous women","volume":"156","author":"Labrecque","year":"1997","journal-title":"CMAJ"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0090","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0002-9378(97)70506-4","article-title":"Determinants of vaginal-perineal integrity and pelvic floor functioning in childbirth","volume":"176","author":"Klein","year":"1997","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0095","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1016\/S0002-9378(99)70104-3","article-title":"Episiotomy, operative vaginal delivery, and significant perinatal trauma in nulliparous women","volume":"181","author":"Robinson","year":"1999","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0100","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/S0020-7292(00)00305-2","article-title":"Incidence and risk factors for third degree perineal tears","volume":"71","author":"Jones","year":"2000","journal-title":"Int J Gynaecol Obstet"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0105","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1111\/j.1471-0528.2000.tb11093.x","article-title":"Anal sphincter tears: prospective study of obstetric risk factors","volume":"107","author":"Samuelsson","year":"2000","journal-title":"BJOG"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0110","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1067\/mob.2000.105403","article-title":"Severe perineal lacerations during vaginal delivery: the University of Miami experience","volume":"182","author":"Angioli","year":"2000","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0115","first-page":"383","article-title":"Risk factors for third degree perineal ruptures during delivery","volume":"108","author":"de Leeuw","year":"2001","journal-title":"BJOG"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0120","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1034\/j.1600-0412.2001.080003229.x","article-title":"Third and fourth degree perineal tears. Predictor factors in a referral hospital","volume":"80","author":"Jander","year":"2001","journal-title":"Acta Obstet Gynecol Scand"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0125","first-page":"752","article-title":"Risk factors for third-degree perineal tears in vaginal delivery, with an analysis of episiotomy types","volume":"46","author":"Bodner-Adler","year":"2001","journal-title":"J Reprod Med"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0130","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1055\/s-2002-33088","article-title":"Risk factors for severe perineal tear: can we do better?","volume":"19","author":"Riskin-Mashiah","year":"2002","journal-title":"Am J Perinatol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0135","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.ajog.2004.02.064","article-title":"Incidence, severity, and determinants of perineal pain after vaginal delivery: a prospective cohort study","volume":"191","author":"Macarthur","year":"2004","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0140","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1111\/j.1471-0528.2005.00835.x","article-title":"Does the angle of episiotomy affect the incidence of anal sphincter injury?","volume":"113","author":"Eogan","year":"2006","journal-title":"BJOG"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0145","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1016\/j.ajog.2004.09.035","article-title":"Factors predicting severe perineal trauma during childbirth: role of forceps delivery routinely combined with mediolateral episiotomy","volume":"192","author":"Hudelist","year":"2005","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0150","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s00404-004-0610-5","article-title":"Third degree perineal tears in a university medical center where midline episiotomies are not performed","volume":"271","author":"Sheiner","year":"2005","journal-title":"Arch Gynecol Obstet"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0155","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1080\/00016340500408283","article-title":"The role of mediolateral episiotomy during labour: analysis of risk factors for obstetric anal sphincter tears","volume":"85","author":"Aukee","year":"2006","journal-title":"Acta Obstet Gynecol Scand"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0160","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.midw.2006.04.004","article-title":"An Australian prospective cohort study of risk factors for severe perineal trauma during childbirth","volume":"23","author":"Dahlen","year":"2007","journal-title":"Midwifery"},{"issue":"344","key":"10.1016\/j.ejogrb.2020.02.025_bib0165","first-page":"e1","article-title":"Risk factors for primary and subsequent anal sphincter lacerations: a comparison of cohorts by parity and prior mode of delivery","volume":"196","author":"Lowder","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0170","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.ajog.2006.06.078","article-title":"Operative vaginal delivery and midline episiotomy: a bad combination for the perineum","volume":"195","author":"Kudish","year":"2006","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0175","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s00404-009-1063-7","article-title":"Advanced age is a risk factor for higher grade perineal lacerations during delivery in nulliparous women","volume":"281","author":"Hornemann","year":"2010","journal-title":"Arch Gynecol Obstet"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0180","doi-asserted-by":"crossref","first-page":"e216","DOI":"10.1111\/j.1463-1318.2011.02620.x","article-title":"Risk factors for severe perineal injury during childbirth: a case-control study of 60 consecutive cases","volume":"13","author":"Groutz","year":"2011","journal-title":"Colorectal Dis"},{"issue":"347","key":"10.1016\/j.ejogrb.2020.02.025_bib0185","first-page":"e1","article-title":"Third- and fourth-degree perineal tears: prevalence and risk factors in the third millennium","volume":"204","author":"Groutz","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0190","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.wombi.2014.10.007","article-title":"Risk factors for severe perineal trauma during vaginal childbirth: a Western Australian retrospective cohort study","volume":"28","author":"Hauck","year":"2015","journal-title":"Women Birth"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0195","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ejogrb.2014.08.031","article-title":"Identification of women at high risk for severe perineal lacerations","volume":"182","author":"Schmitz","year":"2014","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0200","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1038\/jp.2014.103","article-title":"Severe perineal laceration during operative vaginal delivery: the impact of occiput posterior position","volume":"34","author":"Hirsch","year":"2014","journal-title":"J Perinatol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0205","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.tjog.2013.07.002","article-title":"Prevalence and contributing factors of severe perineal damage following episiotomy-assisted vaginal delivery","volume":"53","author":"Hsieh","year":"2014","journal-title":"Taiwan J Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0210","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s12884-015-0469-4","article-title":"The impact of first birth obstetric anal sphincter injury on the subsequent birth: a population-based linkage study","volume":"15","author":"Ampt","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0215","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1007\/s00192-015-2863-x","article-title":"Shoulder dystocia and associated manoeuvres as risk factors for perineal trauma","volume":"27","author":"Gauthaman","year":"2016","journal-title":"Int Urogynecol J"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0220","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00192-015-2795-5","article-title":"Risk factors for severe obstetric perineal lacerations","volume":"27","author":"Vale de Castro Monteiro","year":"2016","journal-title":"Int Urogynecol J"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0225","doi-asserted-by":"crossref","DOI":"10.1155\/2016\/9376592","article-title":"Obesity may Be protective against severe perineal lacerations","author":"Garretto","year":"2016","journal-title":"J Obes"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0230","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/AOG.0000000000001533","article-title":"Simulation training for forceps-assisted vaginal delivery and rates of maternal perineal trauma","volume":"128","author":"Gossett","year":"2016","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0235","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1080\/14767058.2016.1224833","article-title":"Episiotomy and the risk of severe perineal injuries among Korean women","volume":"30","author":"Kwon","year":"2017","journal-title":"J Matern Neonatal Med"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0240","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.ejogrb.2017.12.042","article-title":"Incidence and risk factors of third- and fourth-degree perineal tears in a single Italian scenario","volume":"221","author":"Frigerio","year":"2018","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0245","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s00192-017-3398-0","article-title":"Risk factors for obstetric anal sphincter injuries (OASI) at a tertiary centre in south India","volume":"29","author":"Gundabattula","year":"2018","journal-title":"Int Urogynecol J"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0250","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.3889\/oamjms.2018.253","article-title":"Third and fourth degree perineal tear in four-year period at sestre milosrdnice university hospital center, Zagreb, Croatia","volume":"6","author":"Djakovic","year":"2018","journal-title":"Open Access Maced J Med Sci"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0255","first-page":"1","article-title":"Risk factors for obstetric anal sphincter injuries (OASIS) during vacuum extraction delivery in a university affiliated maternity hospital","author":"Segal","year":"2018","journal-title":"J. Maternal-Fetal Neonatal Med."},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0260","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1038\/s41372-018-0252-2","article-title":"Risk factors for poor perineal outcome after operative vaginal delivery","volume":"38","author":"Wilkie","year":"2018","journal-title":"J Perinatol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0265","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.midw.2018.04.012","article-title":"Factors associated with obstetric anal sphincter injuries in midwife-led birth: a cross sectional study","volume":"62","author":"Tunestveit","year":"2018","journal-title":"Midwifery"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0270","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1111\/jog.13558","article-title":"Incidence and risk factors of severe lacerations during forceps delivery in a single teaching hospital where simulation training is held annually","volume":"44","author":"Sano","year":"2018","journal-title":"J Obstet Gynaecol Res"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0275","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1097\/AOG.0000000000002444","article-title":"Risk factors for the development of obstetric anal sphincter injuries in modern obstetric practice","volume":"131","author":"Ramm","year":"2018","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0280","article-title":"Risk factors for perineal trauma in the primiparous population during non-operative vaginal delivery","author":"D\u2019Souza","year":"2019","journal-title":"Int Urogynecol J"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0285","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s00404-019-05165-1","article-title":"Obstetric perineal tears: risk factors, wound infection and dehiscence: a prospective cohort study","volume":"300","author":"Gommesen","year":"2019","journal-title":"Arch Gynecol Obstet"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0290","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1002\/ijgo.12813","article-title":"Factors associated with obstetric anal sphincter injuries during vacuum delivery among Chinese women","volume":"145","author":"Chen","year":"2019","journal-title":"Int J Gynaecol Obstet"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0295","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1111\/1471-0528.13478","article-title":"Methods of classification for women undergoing induction of labour: a systematic review and novel classification system","volume":"122","author":"Nippita","year":"2015","journal-title":"Bjog Int J Obstet Gynaecol"},{"key":"10.1016\/j.ejogrb.2020.02.025_bib0300","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1111\/aogs.13672","article-title":"Changing incidence of obstetric anal sphincter injuries-A result of formal prevention programs?","volume":"98","author":"Jango","year":"2019","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"5","key":"10.1016\/j.ejogrb.2020.02.025_bib0305","first-page":"636","article-title":"Fuzzy logic and neural networks","volume":"3","author":"Gupta","year":"1992","journal-title":"IEEE Trans Neural Netw"}],"container-title":["European Journal of Obstetrics & Gynecology and Reproductive Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0301211520300932?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0301211520300932?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T05:47:36Z","timestamp":1759556856000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0301211520300932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4]]},"references-count":61,"alternative-id":["S0301211520300932"],"URL":"https:\/\/doi.org\/10.1016\/j.ejogrb.2020.02.025","relation":{},"ISSN":["0301-2115"],"issn-type":[{"value":"0301-2115","type":"print"}],"subject":[],"published":{"date-parts":[[2020,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Risk factors for severe perineal trauma during childbirth: An updated meta-analysis","name":"articletitle","label":"Article Title"},{"value":"European Journal of Obstetrics & Gynecology and Reproductive Biology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ejogrb.2020.02.025","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}]}}