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Obstetric anal sphincter injury involving tears of the rectal sphincter, mucosa, or both may result in rectal incontinence, a serious complication of vaginal birth. To identify risk factors for this form of perineal laceration, investigators retrospectively studied almost 23,000 consecutive singleton term vaginal deliveries within the Kaiser Permanente Northern California health system from 2013 through 2014.
Obstetric anal sphincter injury occurred in 3.6% of spontaneous deliveries and 24.0% of vacuum-assisted deliveries. Major risk factors included vacuum-assisted delivery (adjusted odds ratio, 4.2), ≥3 hours of second-stage labor (aOR, 3.2), midline episiotomy (aOR, 2.9), vaginal birth after cesarean delivery (aOR, 2.9), first birth (aOR,…