Birth-related perineal trauma in low- and middle-income countries: a systematic review and meta-analysis

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Birth-related perineal trauma in low- and middle-income countries : a systematic review and meta-analysis. / Aguiar, Magda; Farley, Amanda; Hope, Lucy; Amin, Adeela; Shah, Pooja ; Manaseki-Holland, Semira.

In: Maternal and Child Health Journal, Vol. 23, No. 8, 15.08.2019, p. 1048-1070.

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@article{1c2603c4d14c4a94829e97c0108e8e33,
title = "Birth-related perineal trauma in low- and middle-income countries: a systematic review and meta-analysis",
abstract = "Introduction Birth-related perineal trauma (BPT) is a common consequence of vaginal births. When poorly managed, BPT can result in increased morbidity and mortality due to infections, haemorrhage, and incontinence. This review aims to collect data on rates of BPT in low- and middle-income countries (LMICs), through a systematic review and meta-analysis. Methods The following databases were searched: Medline, Embase, Latin American and Caribbean Health Sciences Literature (LILACs), and the World Health Organization (WHO) regional databases, from 2004 to 2016. Cross-sectional data on the proportion of vaginal births that resulted in episiotomy, second degree tears or obstetric anal sphincter injuries (OASI) were extracted from studies carried out in LMICs by two independent reviewers. Estimates were meta-analysed using a random effects model; results were presented by type of BPT, parity, and mode of birth. Results Of the 1182 citations reviewed, 74 studies providing data on 334,054 births in 41 countries were included. Five studies reported outcomes of births in the community. In LMICs, the overall rates of BPT were 46% (95% CI 36–55%), 24% (95% CI 17–32%), and 1.4% (95% CI 1.2–1.7%) for episiotomies, second degree tears, and OASI, respectively. Studies were highly heterogeneous with respect to study design and population. The overall reporting quality was inadequate. Discussion Compared to high-income settings, episiotomy rates are high in LMIC medical facilities. There is an urgent need to improve reporting of BPT in LMICs particularly with regards to births taking in community settings.",
keywords = "Episiotomy, OASI, birth-related perineal trauma, systematic review, LMICs",
author = "Magda Aguiar and Amanda Farley and Lucy Hope and Adeela Amin and Pooja Shah and Semira Manaseki-Holland",
year = "2019",
month = aug,
day = "15",
doi = "10.1007/s10995-019-02732-5",
language = "English",
volume = "23",
pages = "1048--1070",
journal = "Maternal and Child Health Journal",
issn = "1092-7875",
publisher = "Springer",
number = "8",

}

RIS

TY - JOUR

T1 - Birth-related perineal trauma in low- and middle-income countries

T2 - a systematic review and meta-analysis

AU - Aguiar, Magda

AU - Farley, Amanda

AU - Hope, Lucy

AU - Amin, Adeela

AU - Shah, Pooja

AU - Manaseki-Holland, Semira

PY - 2019/8/15

Y1 - 2019/8/15

N2 - Introduction Birth-related perineal trauma (BPT) is a common consequence of vaginal births. When poorly managed, BPT can result in increased morbidity and mortality due to infections, haemorrhage, and incontinence. This review aims to collect data on rates of BPT in low- and middle-income countries (LMICs), through a systematic review and meta-analysis. Methods The following databases were searched: Medline, Embase, Latin American and Caribbean Health Sciences Literature (LILACs), and the World Health Organization (WHO) regional databases, from 2004 to 2016. Cross-sectional data on the proportion of vaginal births that resulted in episiotomy, second degree tears or obstetric anal sphincter injuries (OASI) were extracted from studies carried out in LMICs by two independent reviewers. Estimates were meta-analysed using a random effects model; results were presented by type of BPT, parity, and mode of birth. Results Of the 1182 citations reviewed, 74 studies providing data on 334,054 births in 41 countries were included. Five studies reported outcomes of births in the community. In LMICs, the overall rates of BPT were 46% (95% CI 36–55%), 24% (95% CI 17–32%), and 1.4% (95% CI 1.2–1.7%) for episiotomies, second degree tears, and OASI, respectively. Studies were highly heterogeneous with respect to study design and population. The overall reporting quality was inadequate. Discussion Compared to high-income settings, episiotomy rates are high in LMIC medical facilities. There is an urgent need to improve reporting of BPT in LMICs particularly with regards to births taking in community settings.

AB - Introduction Birth-related perineal trauma (BPT) is a common consequence of vaginal births. When poorly managed, BPT can result in increased morbidity and mortality due to infections, haemorrhage, and incontinence. This review aims to collect data on rates of BPT in low- and middle-income countries (LMICs), through a systematic review and meta-analysis. Methods The following databases were searched: Medline, Embase, Latin American and Caribbean Health Sciences Literature (LILACs), and the World Health Organization (WHO) regional databases, from 2004 to 2016. Cross-sectional data on the proportion of vaginal births that resulted in episiotomy, second degree tears or obstetric anal sphincter injuries (OASI) were extracted from studies carried out in LMICs by two independent reviewers. Estimates were meta-analysed using a random effects model; results were presented by type of BPT, parity, and mode of birth. Results Of the 1182 citations reviewed, 74 studies providing data on 334,054 births in 41 countries were included. Five studies reported outcomes of births in the community. In LMICs, the overall rates of BPT were 46% (95% CI 36–55%), 24% (95% CI 17–32%), and 1.4% (95% CI 1.2–1.7%) for episiotomies, second degree tears, and OASI, respectively. Studies were highly heterogeneous with respect to study design and population. The overall reporting quality was inadequate. Discussion Compared to high-income settings, episiotomy rates are high in LMIC medical facilities. There is an urgent need to improve reporting of BPT in LMICs particularly with regards to births taking in community settings.

KW - Episiotomy

KW - OASI

KW - birth-related perineal trauma

KW - systematic review

KW - LMICs

UR - http://www.scopus.com/inward/record.url?scp=85064243543&partnerID=8YFLogxK

U2 - 10.1007/s10995-019-02732-5

DO - 10.1007/s10995-019-02732-5

M3 - Article

C2 - 30915627

VL - 23

SP - 1048

EP - 1070

JO - Maternal and Child Health Journal

JF - Maternal and Child Health Journal

SN - 1092-7875

IS - 8

ER -