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. 2022 Apr 22:56:26.
doi: 10.11606/s1518-8787.2022056003908. eCollection 2022.

Episiotomy in Southern Brazil: prevalence, trend, and associated factors

Juraci A Cesar  1 , Luana P Marmitt  2 , Raúl A Mendoza-Sassi  1
Affiliations

Episiotomy in Southern Brazil: prevalence, trend, and associated factors

Juraci A Cesar et al. Rev Saude Publica. .

Abstract

Objective: To identify and analyze the prevalence, trend, and factors associated with episiotomy in Rio Grande, in the state of Rio Grande do Sul, Southern Brazil.

Methods: A single, standardized questionnaire was applied to all pregnant women, residents in the municipality of Rio Grande, who had children in local hospitals between January 1 and December 12 of the years 2007, 2010, 2013, 2016 e 2019. Demographic and socioeconomic characteristics were investigated, as well as the assistance received during pregnancy and delivery. Chi-square test was used to compare proportions and Poisson regression with robust variance adjustment was used for multivariable analysis. Prevalence ratio (PR) was used as effect measure.

Results: Among the 12,645 births that occurred in the five years, 5,714 (45.2%) were vaginal delivery. Of these mothers, 2,930 (51.3%; 95%CI: 50.0%-52.6%) underwent episiotomy. Over this period, the episiotomy rate decreased from 70.9% (68.4-73.5) in 2007 to 19.4% (17.1-21.7) in 2019. Adjusted analysis showed a high PR of episiotomy occurrence among women who were young (PR = 2.23; 95%CI: 1.89-2.63), had higher education (PR = 1.21; 95%Cl: 1.03-1.42), had a higher family income (PR = 1.25; 95%CI: 1.10-1.41), were primiparous (PR = 3.41; 95%CI: 2.95-3.95), had prenatal care in the private sector (PR = 1.25; 95%CI: 1.07-1.46), had oxytocin-induced labor (PR = 1.18; 95%CI:1.09-1.27), underwent forceps (PR = 1.32; 95%CI: 1.16-1.50), and whose newborn weighed 4,000 g or more (PR = 1.43; 95%CI: 1.14-1.80).

Conclusion: Although the prevalence of episiotomy fell sharply within the studied period, its occurrence is more likely among women at lower risk of birth complications.

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Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

Figures

Figure
Figure. Occurrence of episiotomy between 2007 and 2019. Rio Grande, RS, Brazil. (n = 5,714).
See this image and copyright information in PMC

References

    1. Barjon K, Mahdy. Episiotomy: continuing education activity. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2021. [cited 2021 Aug 21]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546675/
    1. Ghulmiyyah L, Sinno S, Mirza F, Finianos E, Nassar AH. Episiotomy: history, present and future – a review. J Matern Fetal Neonatal Med. 2020 Apr 26:1-6. 10.1080/14767058.2020.1755647. Epub ahead of print. - DOI - PubMed
    1. Shmueli A, Benziv RG, Hiersch L, Ashwal E, Aviram R, Yogev Y, et al. Episiotomy: risk factors and outcomes. J Matern Fetal Neonatal Med. 2017;30(3):251-6. 10.3109/14767058.2016.1169527 - DOI - PubMed
    1. Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev. 2017;(2):CD000081. 10.1002/14651858.CD000081.pub3 - DOI - PMC - PubMed
    1. Schantz C, Sim KL, Ly EM, Barennes H, Sudaroth S, Goyet S. Reasons for routine episiotomy: a mixed-methods study in a large maternity hospital in Phnom Penh, Cambodia. Reprod Health Matters. 2015;23(45):68-77. 10.1016/j.rhm.2015.06.012 - DOI - PubMed