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Time trends in episiotomy and severe perineal tears in Portugal: a nationwide register-based study

dc.contributor.authorTeixeira, Cristina
dc.contributor.authorLorthe, Elsa
dc.contributor.authorBarros, Henrique
dc.date.accessioned2023-01-30T15:12:21Z
dc.date.available2023-01-30T15:12:21Z
dc.date.issued2022
dc.description.abstractRates of episiotomy and severe perineal tears (SPT) are indicators of the quality of obstetric care. Time-trends in the reported occurrence of episiotomy and SPT can contribute to understand both, changes in care and in the frequency of risk factors. Therefore, we aimed to estimate time trends in the frequency of SPT in Portugal and its relationship with episiotomy. Methods: We conducted a nationwide register-based study using data from the national inpatient database of all Portuguese public hospitals between 2000 and 2015. Time-trend analysis using joinpoint regression models was performed to identify trends (joinpoints) and compare time changes in the prevalence of SPT and risk factors expressed as annual percentage changes (APC) with 95% Confdence Intervals (95% CI). Poisson regression models were ftted to estimate whether time-trends in SPT rates were explained by changes in risk factors and to assess the association between episiotomy and SPT. Adjusted relative risk (aRR) and their respective 95% CI were obtained. Results: From 908,999 singleton vaginal deliveries, 20.6% were instrumental deliveries, 76.7% with episiotomy and 0.56% were complicated by SPT. Among women with non-instrumental deliveries and no episiotomy SPT decreased from 2009 onwards (1.3% to 0.7%), whereas SPT kept increasing in women with episiotomy for both non-instrumental (0.1% in 2000 to 0.4% in 2015) and instrumental deliveries (0.7% in 2005 to 2.3% in 2015). Time-trends in potential risk factors did not explain the observed increase in SPT. Episiotomy was associated with a decrease in SPT with adjusted RR varying between 2000 and 2015 from 0.18 (95%CI:0.13–0.25) to 0.59 (95%CI:0.44–0.79) for non-instrumental deliv eries and from 0.45 (95%CI:0.25–0.81) to 0.50 (95%CI:0.40–0.72) for instrumental deliveries. Conclusions: Our fndings suggest that episiotomy rate could safely further decrease as the main factor driving SPT rates seems to be an increase in awareness and reporting of SPT particularly among women who underwent an episiotomypt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationTeixeira, Cristina: Lorthe, Elsa ; Barros, Henrique (2022). Time trends in episiotomy and severe perineal tears in Portugal: a nationwide register-based study. BMC Pregnancy and Childbirth. ISSN 1471-2393, p. 1-10pt_PT
dc.identifier.doi10.1186/s12884-022-05314-6pt_PT
dc.identifier.issn1471-2393
dc.identifier.urihttp://hdl.handle.net/10198/26699
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMCpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectSevere perineal tearspt_PT
dc.subjectEpisiotomypt_PT
dc.subjectTime-trendspt_PT
dc.subjectObstetric interventionpt_PT
dc.subjectWomen’s healthpt_PT
dc.titleTime trends in episiotomy and severe perineal tears in Portugal: a nationwide register-based studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage10pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleBMC Pregnancy and Childbirthpt_PT
oaire.citation.volume22pt_PT
person.familyNameTeixeira
person.givenNameCristina
person.identifier.ciencia-id6E12-F2A0-568F
person.identifier.orcid0000-0001-5194-5141
person.identifier.ridO-2296-2013
person.identifier.scopus-author-id55207402700
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication9037c83c-43c1-4714-ad3e-9f307dd1d89f
relation.isAuthorOfPublication.latestForDiscovery9037c83c-43c1-4714-ad3e-9f307dd1d89f

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