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dc.contributor.authorRygh, Astriden_US
dc.contributor.authorSkjeldestad, Finn Egilen_US
dc.contributor.authorKørner, Hartwigen_US
dc.contributor.authorEggebø, Torbjørn Moeen_US
dc.date.accessioned2014-12-30T11:28:02Z
dc.date.available2014-12-30T11:28:02Z
dc.date.issued2014-07-24eng
dc.identifier.issn2044-6055
dc.identifier.urihttps://hdl.handle.net/1956/9056
dc.description.abstractObjective To assess the association of oxytocin augmentation with obstetric anal sphincter injury among nulliparous women. Design Population-based, case–control study. Setting Primary and secondary teaching hospital serving a Norwegian region. Population 15 476 nulliparous women with spontaneous start of labour, single cephalic presentation and gestation ≥37 weeks delivering vaginally between 1999 and 2012. Methods Based on the presence or absence of oxytocin augmentation, episiotomy, operative vaginal delivery and birth weight (<4000 vs ≥4000 g), we modelled in logistic regression the best fit for prediction of anal sphincter injury. Within the modified model of main exposures, we tested for possible confounding, and interactions between maternal age, ethnicity, occiput posterior position and epidural analgaesia. Main outcome measure Obstetric anal sphincter injury. Results Oxytocin augmentation was associated with a higher OR of obstetric anal sphincter injuries in women giving spontaneous birth to infants weighing <4000 g (OR 1.8; 95% CI 1.5 to 2.2). Episiotomy was not associated with sphincter injuries in spontaneous births, but with a lower OR in operative vaginal deliveries. Spontaneous delivery of infants weighing ≥4000 g was associated with a threefold higher OR, and epidural analgaesia was associated with a 30% lower OR in comparison to no epidural analgaesia. Conclusions Oxytocin augmentation was associated with a higher OR of obstetric anal sphincter injuries during spontaneous deliveries of normal-size infants. We observed a considerable effect modification between the most important factors predicting anal sphincter injuries in the active second stage of labour.en_US
dc.language.isoengeng
dc.publisherBMJeng
dc.relation.ispartof<a href="http://hdl.handle.net/1956/11388" target="blank">Obstetric anal sphincter injuries. A population-based study of improvement of care</a>
dc.rightsAttribution-NonCommercial CC BY-NCeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc/3.0/eng
dc.titleAssessing the association of oxytocin augmentation with obstetric anal sphincter injury in nulliparous women: A population-based, case-control studyen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2014-12-30T11:24:01Z
dc.description.versionpublishedVersionen_US
dc.source.articlenumbere004592
dc.identifier.doihttps://doi.org/10.1136/bmjopen-2013-004592
dc.identifier.cristin1150445
dc.source.journalBMJ Open
dc.source.404
dc.source.147


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Except where otherwise noted, this item's license is described as Attribution-NonCommercial CC BY-NC