{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T22:41:25Z","timestamp":1793572885050,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T00:00:00Z","timestamp":1535500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Evidence Based Medicine"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the incidence rates and risk factors for episiotomy during vaginal childbirth in a Western China context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective hospital\u2010based cohort study was conducted using computerized data of 3721 singleton vaginal deliveries after 28\u00a0weeks of gestation. Women who underwent episiotomy were compared with those who did not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall prevalence of episiotomy was 44.0% (1636\/3721); 52.9% (1458\/2756) among primiparas and 18.4% (178\/965) among multiparas (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Adjusted risk factors significantly associated with episiotomy included primiparity, prolonged second stage of labor, and labor\u2010management personnel. Risk factors specific to primiparas were increasing maternal age (per year) (OR\u00a0=\u00a01.04, 95% CI 1.01 to 1.07, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.035), increasing biparietal diameter (per centimeter) (OR\u00a0=\u00a01.40, 95% CI 1.06 to 1.84, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.017), first stage of labor beyond 10\u2010hour (OR\u00a0=\u00a01.36, 95% CI 1.10 to 1.68, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.005), and birth weight (per 100\u00a0g) (OR\u00a0=\u00a01.06, 95% CI 1.03 to 1.09, <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001). Birth weight resulted in an adjusted risk increase of 6.1% among primiparas for every 100 additional grams of birth weight. For the analysis stratified by labor\u2010management personnel, moderately experienced midwifery was a risk factor of episiotomy (OR\u00a0=\u00a01.76, 95% CI 1.21 to 2.56, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.003); midwives with bachelor's degree (OR\u00a0=\u00a01.47, 95% CI 1.15 to 1.88, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.002), and obstetricians with doctor's degree (OR\u00a0=\u00a02.00, 95% CI 1.18 to 3.39, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.010) were most likely to perform episiotomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Episiotomy is still commonly performed in Western China. A survey of maternity care professionals\u2019 knowledge of and attitudes towards episiotomy is urgently required to explore the complex reasons for conducting episiotomy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jebm.12316","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T11:29:50Z","timestamp":1535628590000},"page":"233-241","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Risk factors for episiotomy during vaginal childbirth: A retrospective cohort study in Western China"],"prefix":"10.1111","volume":"11","author":[{"given":"Mengqin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics West China Second University Hospital Sichuan University  Chengdu P. R. China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education  Chengdu P. R. 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