{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T06:07:17Z","timestamp":1783836437485,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2020\u201000711"],"award-info":[{"award-number":["2020\u201000711"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,8]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Second\u2010degree perineal tears and episiotomies, involving the bulbocavernosus and\/or superficial transverse perineal muscles, are common after vaginal birth and may lead to wound dehiscence, infection, and long\u2010term pelvic floor dysfunction. Despite this, risk factors for deep wound dehiscence involving perineal musculature remain insufficiently studied. This study aimed to identify risk factors for wound dehiscence in second\u2010degree tears and episiotomies to inform potential use of antibiotic prophylaxis.<\/jats:p>\n <\/jats:sec>\n \n Material and Methods<\/jats:title>\n \n A single\u2010center case\u2013control study (1:2 ratio) was conducted including 105 cases with 2nd degree perineal tears or episiotomies complicated by deep wound dehiscence, diagnosed within two weeks postpartum and 210 controls with second\u2010degree tears or episiotomies without dehiscence. Exposure data were retrieved from medical records. Univariate analyses were performed on a priori selected exposure variables, using Mann\u2013Whitney\n U<\/jats:italic>\n and Fisher's exact tests. Variable selection used Lasso regression with leave\u2010one\u2010out cross\u2010validation. Multivariate logistic regression generated adjusted odds ratios (aOR). Statistical significance was set at\n p<\/jats:italic>\n \u2009<\u20090.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Women with wound dehiscence were more often vaginal primiparas (87% vs 69%,\n p<\/jats:italic>\n \u2009<\u20090.001) and had higher rates of episiotomy (33% vs 7%,\n p<\/jats:italic>\n \u2009<\u20090.001). Intrapartum antibiotics were administered less frequently among cases (7% vs 20%,\n p<\/jats:italic>\n \u2009=\u20090.002). Cases had longer second stage of labor, more active pushing, and greater postpartum bleeding. After multivariate adjustment, only episiotomy (aOR 4.40, 95% CI 2.10\u20139.64) and intrapartum antibiotic administration (aOR 0.21, 95% CI 0.07\u20130.50) remained significantly associated with wound dehiscence.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Episiotomy substantially increased the risk of deep perineal wound dehiscence compared with spontaneous second\u2010degree perineal tears, while intrapartum antibiotics were protective. These findings support selective episiotomy use and suggest that antibiotic prophylaxis may reduce this risk in women with second\u2010degree perineal tears or episiotomies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aogs.70285","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:56:23Z","timestamp":1781848583000},"page":"1623-1628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors associated with deep perineal wound dehiscence after second\u2010degree perineal tears or episiotomy"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5744-491X","authenticated-orcid":false,"given":"Denise","family":"Golmann","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Stockholm South General Hospital (S\u00f6dersjukhuset) Stockholm Sweden"},{"name":"Department of Clinical Science and Education, Stockholm South General Hospital Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefin","family":"Hedstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Stockholm South General Hospital (S\u00f6dersjukhuset) Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Epstein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Stockholm South General Hospital (S\u00f6dersjukhuset) Stockholm Sweden"},{"name":"Department of Clinical Science and Education, Stockholm South General Hospital Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"Bergman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Stockholm South General Hospital (S\u00f6dersjukhuset) Stockholm Sweden"},{"name":"Department of Clinical Science and Education, Stockholm South General Hospital Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-59"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-006-0246-z"},{"key":"e_1_2_14_4_1","volume-title":"Anatomy, Abdomen and Pelvis, Perineal Body","author":"Siccardi MA","year":"2024"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.06.008"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13119"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003653"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04964-w"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/2495105"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2022.05.035"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2025-084312"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30773-1"},{"key":"e_1_2_14_13_1","article-title":"Systematic review of the incidence of wound infection and dehiscence following childbirth\u2010related perineal trauma","volume":"126","author":"Jones K","year":"2019","journal-title":"BJOG"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.05.012"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-025-06395-5"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12843"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-079014"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2018.1476473"},{"key":"e_1_2_14_19_1","article-title":"Perineal care. 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