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Association between birth weight and head circumference and obstetric anal sphincter injury severity

Henry H Chill1, Michal Lipschuetz2, Eyal Atias2

  • 1Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel; Division of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|September 6, 2021
PubMed

Insights

Obstetric anal sphincter injuries (OASI) are more severe with higher birth weight (BW) and head circumference (HC). Neonates with BW or HC at or above the 90th percentile are at increased risk for severe OASI.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Neonatal Health

Background:

  • Obstetric anal sphincter injuries (OASI) are significant postpartum complications.
  • Identifying risk factors for OASI severity is crucial for clinical management.
  • Birth weight (BW) and neonatal head circumference (HC) are known potential contributors.

Purpose of the Study:

  • To identify risk factors associated with increasing OASI severity.
  • To evaluate the correlation between OASI severity and BW and HC.
  • To analyze specific combinations of BW and HC percentiles in relation to OASI.

Main Methods:

  • Retrospective cohort study of 150,221 deliveries (2003-2019).
  • Comparison of patients with varying degrees of OASI (3rd and 4th degree tears) versus no OASI.
  • Analysis of four groups based on BW and HC at or above the 90th percentile.

Main Results:

  • Increased fetal size parameters correlated with a higher rate of severe OASI.
  • Neonates with HC ≥ 90th percentile showed a particularly increased risk.
  • Multinomial regression indicated gradually increasing odds of OASI with tear severity for BW ≥ 90th percentile and combined high BW/HC.

Conclusions:

  • Elevated birth weight and head circumference (≥ 90th percentile) are significantly correlated with increased OASI severity.
  • These anthropometric measures serve as important indicators for OASI risk assessment.
  • Further research may explore targeted interventions for high-risk pregnancies.
Abstract

Keywords:
Birth weightHead circumferenceObstetric anal sphincter injuryPerineal laceration

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