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Changing incidence of obstetric anal sphincter injuries - a result of formal prevention programs?

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@article{fd35198a059a4634bcde7d9c4959184e,
title = "Changing incidence of obstetric anal sphincter injuries - a result of formal prevention programs?",
abstract = "INTRODUCTION: Obstetric anal sphincter injuries (OASIS) are serious complications to vaginal delivery causing anal incontinence in 50{\%} of the women at long term. In Norway, the incidence of OASIS has been significantly reduced from 4-5{\%} to 1-2{\%} after implementation of prevention programs focusing on perineal protection. The aim of our study was to evaluate whether implementation of formal prevention programs was associated with a reduced incidence of OASIS over time.MATERIAL AND METHODS: We performed a historical cohort study, evaluating incidence, change of incidence and risk factors of OASIS during the years 2011-2015 at the four delivery departments in the Capital Region of Denmark. Two of the four departments implemented formal prevention programs in 2012-2013. We performed trend tests and uni- and multivariable analyses, adjusting for important risk factors and calculating interactions between risk factors.RESULTS: There were 75 173 vaginal deliveries during the study period and of those, 2 670 (3.6{\%}) were complicated by OASIS. The incidence of OASIS decreased during the study period from 4.3{\%} (n=636) in 2011 to 2.6{\%} (n=399) in 2015. There was a significant decrease in the incidence of OASIS both at the departments with formal prevention programs and those without. After adjustment for other important risk factors of OASIS, we found no significant difference in the risk reduction between departments with and without formal prevention programs.CONCLUSIONS: We found that the general focus on prevention of OASIS in Denmark was associated with a significant decrease in the incidence of OASIS, but implementation of formal prevention programs did not lead to a further reduction. It is possible, that more rigorous interventions at the hospitals with formal prevention programs could have resulted in a significant difference in incidence of OASIS. This article is protected by copyright. All rights reserved.",
author = "Hanna Jang{\"o} and Westergaard, {Hanne Brix} and Anette Kjaerbye-Thygesen and Jens Langhoff-Roos and Jeannet Lauenborg",
note = "{\circledC} 2019 Nordic Federation of Societies of Obstetrics and Gynecology.",
year = "2019",
month = "11",
doi = "10.1111/aogs.13672",
language = "English",
volume = "98",
pages = "1455--1463",
journal = "Acta Obstetricia et Gynecologica Scandinavica",
issn = "0001-6349",
publisher = "Informa Healthcare",
number = "11",

}

RIS

TY - JOUR

T1 - Changing incidence of obstetric anal sphincter injuries - a result of formal prevention programs?

AU - Jangö, Hanna

AU - Westergaard, Hanne Brix

AU - Kjaerbye-Thygesen, Anette

AU - Langhoff-Roos, Jens

AU - Lauenborg, Jeannet

N1 - © 2019 Nordic Federation of Societies of Obstetrics and Gynecology.

PY - 2019/11

Y1 - 2019/11

N2 - INTRODUCTION: Obstetric anal sphincter injuries (OASIS) are serious complications to vaginal delivery causing anal incontinence in 50% of the women at long term. In Norway, the incidence of OASIS has been significantly reduced from 4-5% to 1-2% after implementation of prevention programs focusing on perineal protection. The aim of our study was to evaluate whether implementation of formal prevention programs was associated with a reduced incidence of OASIS over time.MATERIAL AND METHODS: We performed a historical cohort study, evaluating incidence, change of incidence and risk factors of OASIS during the years 2011-2015 at the four delivery departments in the Capital Region of Denmark. Two of the four departments implemented formal prevention programs in 2012-2013. We performed trend tests and uni- and multivariable analyses, adjusting for important risk factors and calculating interactions between risk factors.RESULTS: There were 75 173 vaginal deliveries during the study period and of those, 2 670 (3.6%) were complicated by OASIS. The incidence of OASIS decreased during the study period from 4.3% (n=636) in 2011 to 2.6% (n=399) in 2015. There was a significant decrease in the incidence of OASIS both at the departments with formal prevention programs and those without. After adjustment for other important risk factors of OASIS, we found no significant difference in the risk reduction between departments with and without formal prevention programs.CONCLUSIONS: We found that the general focus on prevention of OASIS in Denmark was associated with a significant decrease in the incidence of OASIS, but implementation of formal prevention programs did not lead to a further reduction. It is possible, that more rigorous interventions at the hospitals with formal prevention programs could have resulted in a significant difference in incidence of OASIS. This article is protected by copyright. All rights reserved.

AB - INTRODUCTION: Obstetric anal sphincter injuries (OASIS) are serious complications to vaginal delivery causing anal incontinence in 50% of the women at long term. In Norway, the incidence of OASIS has been significantly reduced from 4-5% to 1-2% after implementation of prevention programs focusing on perineal protection. The aim of our study was to evaluate whether implementation of formal prevention programs was associated with a reduced incidence of OASIS over time.MATERIAL AND METHODS: We performed a historical cohort study, evaluating incidence, change of incidence and risk factors of OASIS during the years 2011-2015 at the four delivery departments in the Capital Region of Denmark. Two of the four departments implemented formal prevention programs in 2012-2013. We performed trend tests and uni- and multivariable analyses, adjusting for important risk factors and calculating interactions between risk factors.RESULTS: There were 75 173 vaginal deliveries during the study period and of those, 2 670 (3.6%) were complicated by OASIS. The incidence of OASIS decreased during the study period from 4.3% (n=636) in 2011 to 2.6% (n=399) in 2015. There was a significant decrease in the incidence of OASIS both at the departments with formal prevention programs and those without. After adjustment for other important risk factors of OASIS, we found no significant difference in the risk reduction between departments with and without formal prevention programs.CONCLUSIONS: We found that the general focus on prevention of OASIS in Denmark was associated with a significant decrease in the incidence of OASIS, but implementation of formal prevention programs did not lead to a further reduction. It is possible, that more rigorous interventions at the hospitals with formal prevention programs could have resulted in a significant difference in incidence of OASIS. This article is protected by copyright. All rights reserved.

UR - http://www.scopus.com/inward/record.url?scp=85068505831&partnerID=8YFLogxK

U2 - 10.1111/aogs.13672

DO - 10.1111/aogs.13672

M3 - Journal article

VL - 98

SP - 1455

EP - 1463

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

SN - 0001-6349

IS - 11

ER -

ID: 57292453