{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T02:04:19Z","timestamp":1783735459312,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,2,14]],"date-time":"2013-02-14T00:00:00Z","timestamp":1360800000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Changes in clinical practice and in the characteristics of childbearing women have the potential to influence the rate of obstetric anal sphincter injuries (<jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>). To date, little investigation has been undertaken to assess the effect of risk factor trends for the <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ustralian population on <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To ascertain the <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> rates amongst singleton vaginal births \u226537 weeks gestation in <jats:styled-content style=\"fixed-case\">NSW<\/jats:styled-content>, 2001 \u2013 2009; to determine risk factor effect sizes and trends; and to compare predicted with observed <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using two linked population\u2010based data sets, risk factors for <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> were determined by logistic regression. Contingency tables and predictive modelling were used to determine trends and predicted rates of <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The OASIS rate increased from 2.2% in 2001 to 2.9% in 2009. Highest risks were for forceps deliveries without episiotomy (primiparas <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 6.10, multiparas <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 6.15), followed by multiparas with no previous vaginal birth (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 5.61). High birthweight, vacuum delivery and <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>sian country of birth posed risks for all women. The greatest risk factor trends were increases in <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>sian country of birth and vacuum delivery, while the greatest trend amongst protective factors was an increase in maternal age \u226535\u00a0years for primiparas. Predicted <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> rates were lower than observed rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In an environment of changing demographic and clinical risk factors, the <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> rate has increased. This increase is only minimally explained by the identified risk factors and may be related to other unmeasured risk factors or a possible increase in clinical ascertainment and\/or documentation of <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12038","type":"journal-article","created":{"date-parts":[[2013,2,14]],"date-time":"2013-02-14T06:34:33Z","timestamp":1360823673000},"page":"9-16","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["Trends in obstetric anal sphincter injuries and associated risk factors for vaginal singleton term births in <scp>N<\/scp>ew <scp>S<\/scp>outh <scp>W<\/scp>ales 2001\u20132009"],"prefix":"10.1111","volume":"53","author":[{"given":"Amanda J","family":"Ampt","sequence":"first","affiliation":[{"name":"Clinical and Population Perinatal Health Research Kolling Institute of Medical Research University of Sydney St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane B","family":"Ford","sequence":"additional","affiliation":[{"name":"Clinical and Population Perinatal Health Research Kolling Institute of Medical Research University of Sydney St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine L","family":"Roberts","sequence":"additional","affiliation":[{"name":"Clinical and Population Perinatal Health Research Kolling Institute of Medical Research University of Sydney St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M","family":"Morris","sequence":"additional","affiliation":[{"name":"Clinical and Population Perinatal Health Research Kolling Institute of Medical Research University of Sydney St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,2,14]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"2010","volume-title":"Benchmarking Maternity Care 2008\u201009","author":"Thompson J"},{"key":"e_1_2_8_3_1","unstructured":"Royal College of Obstetricians and Gynaecologists.Management of Third and Fourth Degree Perineal Tears Green\u2010top Guideline No 27 2007. 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