AI Article Synopsis
- High birth weight and gestational diabetes are linked to an increased risk of obstetric anal sphincter injury during childbirth, as previous studies suggest.
- A systematic review and meta-analysis of twelve cohort studies showed a slightly higher prevalence of this injury in women with gestational diabetes (2.40%) compared to those without (2.31%).
- The findings indicate that primiparous women (first-time mothers) with gestational diabetes have a significantly higher risk of injury (6.65%) compared to their counterparts without diabetes, while this risk is not as pronounced in multiparous women (those who have given birth before).
Article Abstract
Introduction And Hypothesis: High birth weight increases the risk of obstetric anal sphincter injury. Macrosomia is a well-known complication in pregnancies complicated by gestational diabetes mellitus. The aim of this study was to investigate whether gestational diabetes is a risk factor for obstetric anal sphincter injury. We hypothesized that women with gestational diabetes have an increased risk of obstetric anal sphincter injury.
Methods: We performed a systematic review and meta-analysis using the PubMed and Embase databases. Studies including numbers on women with and without gestational diabetes and with and without obstetric anal sphincter injury were included. Studies were assessed using the SIGN-methodology checklist to evaluate the quality and risk of bias. Extracted data was analyzed using RevMan 5.4 and the statistical software R.
Results: Twelve cohort studies were included for the meta-analyses. Overall, we found a slightly increased prevalence of obstetric anal sphincter injury among the women with gestational diabetes of 2.40% (95% CI; 2.37-2.43) compared to 2.31% (95% CI; 2.30-2.32) in women without diabetes. The meta-analysis revealed increased risk of obstetric anal sphincter injury in the gestational diabetes-group (RR 1.24 [95% CI; 1.12-1.37]) with a high level of heterogeneity (I = 94%). Primiparous women with gestational diabetes had an increased risk of obstetric anal sphincter injury 6.65% (95% CI; 6.18-7.14) compared to 4.98% (95% CI; 4.89-5.08) in the control group, whereas the risk was not significantly increased in multiparous women.
Conclusions: The risk of obstetric anal sphincter injury is increased in primiparous women with gestational diabetes mellitus compared to women without gestational diabetes.
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| http://dx.doi.org/10.1007/s00192-024-05989-9 | DOI Listing |
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