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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 \u201clabored down.\u201d A logistic regression model to predict OASIS was created.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 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%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>When known risk factors for OASIS are accounted for, the effect of laboring down on perineal outcome is negligible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijgo.2015.07.015","type":"journal-article","created":{"date-parts":[[2015,11,5]],"date-time":"2015-11-05T05:28:22Z","timestamp":1446701302000},"page":"188-190","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"title":["A case\u2013control study of the relationship between a passive second stage of labor and obstetric anal sphincter injuries"],"prefix":"10.1002","volume":"132","author":[{"given":"Dana R.","family":"Gossett","sequence":"first","affiliation":[{"name":"Division of General Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Deibel","sequence":"additional","affiliation":[{"name":"Atrium ObGyn Raleigh NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Lewicky\u2010Gaupp","sequence":"additional","affiliation":[{"name":"Division of Female Pelvic Medicine and Reconstructive Surgery Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,11,5]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.308.6933.887"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31820afaf2"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2013.791268"},{"issue":"5","key":"e_1_2_6_5_2","first-page":"732","article-title":"Factors associated with rectal injury in spontaneous deliveries","volume":"73","author":"Green J.R.","year":"1989","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(99)00109-8"},{"issue":"1","key":"e_1_2_6_7_2","first-page":"21","article-title":"Anal sphincter tears at vaginal delivery: risk factors and clinical outcome of primary repair","volume":"94","author":"Zetterstr\u00f6m J.","year":"1999","journal-title":"Obstet Gynecol"},{"issue":"2","key":"e_1_2_6_8_2","first-page":"115","article-title":"Length of second stage of labor as a predictor of perineal outcome after vaginal delivery","volume":"51","author":"Sheiner E.","year":"2006","journal-title":"J Reprod Med"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.12.025"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.09.030"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.1988.tb07806.x"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(93)90478-2"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01445.x"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006672.pub2"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12274"},{"issue":"2","key":"e_1_2_6_16_2","first-page":"260","article-title":"Selected use of midline episiotomy: effect on perineal trauma","volume":"70","author":"Thorp J.M.","year":"1987","journal-title":"Obstet Gynecol"},{"issue":"8886","key":"e_1_2_6_17_2","first-page":"1517","article-title":"Routine vs selective episiotomy: a randomized controlled trial","volume":"342","author":"Argentine Episiotomy Trial Collaborative Group","year":"1993","journal-title":"Lancet"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01960.x"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182639fae"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.08.003"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.08.002"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.105197"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(01)01642-8"}],"container-title":["International Journal of Gynecology &amp; 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