{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T02:03:40Z","timestamp":1783735420082,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T00:00:00Z","timestamp":1588204800000},"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":[[2020,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The assessment of risk factors, including mediolateral episiotomy (MLE), for the recurrence of obstetric anal sphincter injury (rOASI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Population\u2010based cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Data from the nationwide database of the Dutch Perinatal Registry (Perined).<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A cohort of 391\u00a0026 women at term, of whom 9943 had an OASI in their first delivery and had a second vaginal delivery of a liveborn infant in cephalic position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Possible risk factors were tested for statistical significance using univariate and multivariate logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Rate of rOASI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rate of rOASI was 5.8%. Multivariate analysis identified a birthweight of \u22654000\u00a0g (adjusted OR, aOR, 2.1, 95%\u00a0CI 1.6\u20132.6) and a duration of second stage of \u226530\u00a0minutes (aOR 1.8, 95%\u00a0CI 1.4\u20132.3) as statistically significant risk factors for rOASI. Mediolateral episiotomy was associated with a statistically significant lower rate of rOASI in spontaneous vaginal delivery (SVD) (aOR\u00a00.4, 95%\u00a0CI 0.3\u20130.5) and in operative vaginal delivery (OVD) (aOR\u00a00.2, 95%\u00a0CI 0.1\u20130.5).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with a history of OASI have a higher rate of OASI in their next delivery. Duration of the second stage of \u226530\u00a0minutes and a birthweight of \u22654000\u00a0g are significantly associated with an increased rate of rOASI. Mediolateral episiotomy is associated with a significantly lower rate of rOASI in both SVD and OVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Mediolateral episiotomy is associated with a significant lower recurrence rate of OASI in women with an OASI in their first delivery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16263","type":"journal-article","created":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T06:35:15Z","timestamp":1586846115000},"page":"951-956","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Risk factors for the recurrence of obstetrical anal sphincter injury and the role of a mediolateral episiotomy: an analysis of a national registry"],"prefix":"10.1111","volume":"127","author":[{"given":"J","family":"van Bavel","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Amphia Hospital Breda Breda the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ACJ","family":"Ravelli","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics Academic Medical Centre Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Abu\u2010Hanna","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics Academic Medical Centre Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JPWR","family":"Roovers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Academic Medical Centre Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"BW","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JW","family":"de Leeuw","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Ikazia Hospital Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03486.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.02.010"},{"key":"e_1_2_6_4_1","volume-title":"The Management of Third and Fourth Degree Perineal Tears","author":"Royal College of Obstetricians and Gynaecologists","year":"2015"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3304-9"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-015-2893-4"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-019-03983-0"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.11.021"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.07.026"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00835.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13431"},{"key":"e_1_2_6_12_1","volume-title":"Perinatal Care in the Netherlands 2010","author":"The Netherlands Perinatal Registry"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-5456(00)00090-5"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3422-4"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12886"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12184"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-016-3015-7"},{"key":"e_1_2_6_18_1","first-page":"CD000947","article-title":"Continuous and interrupted suturing techniques for repair of episiotomy or second\u2010degree tears","author":"Kettle C","year":"2012","journal-title":"Cochrane Database Syst Rev"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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