{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:03:25Z","timestamp":1792159405319,"version":"4.4.0"},"reference-count":27,"publisher":"Walter de Gruyter GmbH","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2023-0127_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Perineal lacerations are a common complication of vaginal birth, affecting approximately 85\u202f% of patients. Third-and fourth-degree perineal lacerations (3\/4PL) remain a significant cause of physical and emotional distress. We aimed to perform an extensive assessment of potential risk factors for 3\/4PL based on a comprehensive and current US population database.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2023-0127_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective population-based cohort analysis based on the US Centers for Disease Control and Prevention Natality Live Birth online database between 2016\u20132020. Baseline characteristics were compared between women with 3\/4PL and without 3\/4PL by using Pearson\u2019s Chi-squared test with statistical significance set at p&lt;0.05. Bonferroni correction was used to account for multiple comparisons. Multivariable logistic regression was performed to evaluate the association between a variety of potential risk factors and the risk of 3\/4P.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2023-0127_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Asians\/Pacific Islanders had the highest risk of 3\/4PL (2.6\u202f%, aOR 1.74). Gestational hypertension and preeclampsia were associated with increased risk of 3\/4PL (aOR\u00a01.28 and 1.34, respectively), as were both pre-gestational and gestational diabetes (aOR 1.28 and 1.46, respectively). Chorioamnionitis was associated almost double the risk (aOR 1.86). Birth weight was a major risk factor (aOR 7.42 for greater than 4,000\u202fg), as was nulliparity (aOR 9.89).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2023-0127_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We identified several maternal, fetal, and pregnancy conditions that are associated with an increased risk for 3\/4PL. As expected, nulliparity and increased birth weight were associated with the highest risk. Moreover, pregestational and gestational diabetes, hypertensive disorders of pregnancy, Asian\/Pacific Islander race, and chorioamnionitis were identified as novel risk factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2023-0127","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T16:16:05Z","timestamp":1685636165000},"page":"1006-1012","source":"Crossref","is-referenced-by-count":7,"title":["Risk factors associated with third- and fourth-degree perineal lacerations in singleton vaginal deliveries: a comprehensive United States population analysis 2016\u20132020"],"prefix":"10.1515","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7864-4621","authenticated-orcid":false,"given":"Samantha","family":"Gobioff","sequence":"first","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Lenox Hill Hospital\u00a0\u2013 Northwell Health\/Zucker School of Medicine , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erez","family":"Lenchner","sequence":"additional","affiliation":[{"name":"Biostatistics and Data Management , New York University Rory Meyers College of Nursing , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moti","family":"Gulersen","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia , PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2372-7862","authenticated-orcid":false,"given":"Liron","family":"Bar-El","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Lenox Hill Hospital\u00a0\u2013 Northwell Health\/Zucker School of Medicine , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amos","family":"Gr\u00fcnebaum","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Lenox Hill Hospital\u00a0\u2013 Northwell Health\/Zucker School of Medicine , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank A.","family":"Chervenak","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Lenox Hill Hospital\u00a0\u2013 Northwell Health\/Zucker School of Medicine , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran","family":"Bornstein","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Lenox Hill Hospital\u00a0\u2013 Northwell Health\/Zucker School of Medicine , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2023,6,1]]},"reference":[{"key":"2023100415421281322_j_jpm-2023-0127_ref_001","unstructured":"Frohlich, J, Kettle, C. 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