{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T02:14:24Z","timestamp":1778552064346,"version":"3.51.4"},"reference-count":16,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Obesity"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p><jats:italic>Objective.<\/jats:italic>To determine if there is an association between BMI and 3rd- or 4th-degree perineal lacerations in normal spontaneous and operative vaginal deliveries.<jats:italic>Study Design.<\/jats:italic>We performed a retrospective case control study using a large obstetric quality improvement database over a six-year period. Cases were identified as singleton gestations with third- and fourth-degree lacerations. Controls were obtained randomly from the database of patients without third- or fourth-degree lacerations in a 1\u2009:\u20091 ratio. Univariate and multivariate logistic regression analyses were performed.<jats:italic>Results.<\/jats:italic>Of 32,607 deliveries, 22,011 (67.5%) charts with BMI documented were identified. Third- or fourth-degree lacerations occurred in 2.74% (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">605<\/mml:mn><\/mml:math>) of patients. 37% (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">223<\/mml:mn><\/mml:math>) were identified in operative vaginal deliveries. In the univariate analysis, obesity, older maternal age, non-Asian race, and birth weight &lt;4000\u2009g were all protective against 3rd- and 4th-degree lacerations. After controlling for age, race, mode of vaginal delivery, and birth weight, obesity remained significant.<jats:italic>Conclusion.<\/jats:italic>Being obese may protect against third- and fourth-degree lacerations independent of parity, race, birth weight, and mode of delivery.<\/jats:p>","DOI":"10.1155\/2016\/9376592","type":"journal-article","created":{"date-parts":[[2016,5,5]],"date-time":"2016-05-05T21:02:17Z","timestamp":1462482137000},"page":"1-5","source":"Crossref","is-referenced-by-count":22,"title":["Obesity May Be Protective against Severe Perineal Lacerations"],"prefix":"10.1155","volume":"2016","author":[{"given":"Diana","family":"Garretto","sequence":"first","affiliation":[{"name":"Department of Obstetrics & Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY 11794, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian B.","family":"Lin","sequence":"additional","affiliation":[{"name":"Hospitals Insurance Company, Inc., New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen L.","family":"Syn","sequence":"additional","affiliation":[{"name":"Hospitals Insurance Company, Inc., New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Judge","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology and Women\u2019s Health, Albert Einstein College of Medicine\/Montefiore Medical Center, Bronx, NY 10461, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Beckerman","sequence":"additional","affiliation":[{"name":"Bronx Lebanon Hospital, Bronx, NY 10457, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fouad","family":"Atallah","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, NY 11219, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnold","family":"Friedman","sequence":"additional","affiliation":[{"name":"Mount Sinai Beth Israel Hospital, New York, NY 10011, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Brodman","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter S.","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology and Women\u2019s Health, Albert Einstein College of Medicine\/Montefiore Medical Center, Bronx, NY 10461, 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