Striae gravidarum in primiparae

Striae distensae are widely known to occur in pregnancy and aesthetically they can be a cause of great concern for many women. Various factors have been reported to be associated with the development of striae but the results are conflicting.

To observe the prevalence of striae gravidarum in primiparae and identify independent associated risk factors.

An observational analysis of 324 primiparae was conducted within 48 h of delivery. Data was collected in the form of a questionnaire and physical examination. Seventy-two primiparae participated in a pilot study in 1999 and the remaining were assessed over a 4-month period in 2000. Seventeen variables were recorded, and striae graded according to quantity and severity. Fifteen primiparae were excluded prior to analysis.

Fifty-two per cent (161 of 309) of primiparous white women had striae of which 12% (20 of 161) were classified as severe. The most significant risk factor was low maternal age (P < 0.0001). Twenty per cent (14 of 71) of teenagers had severe striae, a finding not seen in women over 30 years of age. Other significant risk factors included maternal body mass index greater than 26 (P = 0.0003), maternal weight gain of more than 15 kg (P = 0.0121) and high neonatal birth weight (P = 0.0135).

Logistic regression analysis demonstrated that maternal age, body mass index, weight gain and neonatal birth weight were independently associated with the occurrence of striae. It appears that the group at highest risk of developing severe striae are teenagers. This finding is important and may provide impetus to explore the pathomechanisms of striae.