{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:20:40Z","timestamp":1782516040990,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,5,20]],"date-time":"2013-05-20T00:00:00Z","timestamp":1369008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate and compare the risk profile of sustaining obstetric anal sphincter injuries (<jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>) and associated risks in five risk groups (low to high), after the <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> rate was reduced from 4.6% to 2.0% following an interventional programme. The main focus of the intervention was on manual assistance during the final part of second stage of labour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A multicentre interventional cohort study with before and after comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Four <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>orwegian obstetric departments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>A total of 40\u00a0154 vaginal deliveries in 2003\u201309.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pre\u2010intervention and postintervention analyses. The associations of <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> with possible risk factors were estimated using odds ratios obtained by logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>Risk factors of <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The risk of sustaining <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> decreased by 59% (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 0.41; 95% confidence interval [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 0.36\u20130.46) after the intervention. Associations with obstetric risks for <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> were largely unchanged after the intervention, including first vaginal delivery (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.84; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.90\u20135.07), birthweight \u22654500\u00a0g (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 4.42; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.68\u20137.27), forceps delivery (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.54; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.99\u20136.29) and mediolateral episiotomy (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.89; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.70\u20131.12). However, the highest reduction of <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>, (65%), was observed in group 0 (low\u2010risk) (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.35; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.24\u20130.51), and a 57% (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.43; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.35\u20130.52), 61% (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.39; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.31\u20130.48), and 58% (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.42; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.30\u20130.60) reduction in groups with one, two and three risk factors, respectively. No change was observed in the group with four risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>After the intervention the most significant decrease of <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> was observed in low\u2010risk births, although the main risk factors for <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> remained unchanged.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12274","type":"journal-article","created":{"date-parts":[[2013,5,20]],"date-time":"2013-05-20T10:48:40Z","timestamp":1369046920000},"page":"83-91","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Risk factors for obstetric anal sphincter injury after a successful multicentre interventional programme"],"prefix":"10.1111","volume":"121","author":[{"given":"M","family":"Stedenfeldt","sequence":"first","affiliation":[{"name":"The Norwegian Continence and Pelvic Floor Centre University Hospital of North Norway Troms\u00f8 Norway"},{"name":"Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences University of Troms\u00f8 Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"\u00d8ian","sequence":"additional","affiliation":[{"name":"Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences University of Troms\u00f8 Troms\u00f8 Norway"},{"name":"Department of Obstetrics and Gynaecology University Hospital of North Norway Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Gissler","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare (THL) Helsinki Finland"},{"name":"Nordic School of Public Health Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Blix","sequence":"additional","affiliation":[{"name":"Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences University of Troms\u00f8 Troms\u00f8 Norway"},{"name":"Department of Clinical Research University Hospital of North Norway Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Pirhonen","sequence":"additional","affiliation":[{"name":"The Norwegian Continence and Pelvic Floor Centre University Hospital of North Norway Troms\u00f8 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