{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T03:21:28Z","timestamp":1789528888417,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2007,9,12]],"date-time":"2007-09-12T00:00:00Z","timestamp":1189555200000},"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":[[2007,10]]},"abstract":"<jats:p><jats:bold>Objective\u2002<\/jats:bold> To assess the role of birth position in the occurrence of anal sphincter tears (AST).<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Observational cohort study.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> South Hospital in Stockholm, a teaching hospital with around 5700 births per year.<\/jats:p><jats:p><jats:bold>Population\u2002<\/jats:bold> Among all 19\u2003151 women who gave birth at the South Hospital during the study period 2002\u201305, 12\u2003782 women met the inclusion criteria of noninstrumental, vaginal deliveries.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Data on birth position and other obstetric factors were analysed in relation to occurrence of AST.<\/jats:p><jats:p><jats:bold>Main outcome measure\u2002<\/jats:bold> Third\u2010 and fourth\u2010degree AST.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> AST occurred in 449 women (3.5%). The trauma was more frequent in primiparous (5.8%) than in multiparous women (1.7%). The highest proportion of AST was found among women who gave birth in lithotomy position (6.9%), followed by squatting position (6.4%). Logistic regression analyses showed that lithotomy (adjusted OR 2.02, 95% CI 1.58\u20132.59) and squatting positions (adjusted OR 2.05, 95% CI 1.09\u20133.82) were associated with a significantly increased risk for AST. Other major risk factors for anal sphincter trauma were primiparity (adjusted OR 3.29, 95% CI 2.55\u20134.25), prolonged second stage of labour &gt;1 hour (adjusted OR 1.52, 95% CI 1.11\u20132.10), infant birthweight more than 4 kg (adjusted OR 2.12, 95% CI 1.64\u20132.72) and large infant head circumference (adjusted OR 1.57, 95% CI 1.23\u20131.99).<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> Lithotomy and squatting position at birth were associated with an increased risk for AST also after control for other risk factors.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2007.01482.x","type":"journal-article","created":{"date-parts":[[2007,9,12]],"date-time":"2007-09-12T16:58:24Z","timestamp":1189616304000},"page":"1266-1272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Risk factors for anal sphincter tears: the importance of maternal position at birth"],"prefix":"10.1111","volume":"114","author":[{"given":"K","family":"Gottvall","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Allebeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Ek\u00e9us","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,9,12]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2003.00260.x"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199312233292601"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199907000-00005"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536x.1999.00011.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.17.2141"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.1998.t01-2-.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1526-9523(01)00205-7"},{"key":"e_1_2_6_9_2","unstructured":"Swedish Medical Birth Registry. 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