A nationwide cross-sectional survey of episiotomy practice in China
Jiangfeng Ye, Yan Chen, Hua Yang, Qian Chen, Yun Huang, Jian Zhao, Lei Tu, Ming Liu, Jun Zhang
Abstract
BACKGROUND: A restrictive use of episiotomy was recommended by the obstetric society in China, but limited information on the epidemiology and the effects of restrictive use of episiotomy on maternal and fetal outcomes have been published. METHODS: The China Labor and Delivery Survey is a cross-sectional investigation with a cluster random sampling scheme in 2015-2016 with the aim to describe detailed epidemiology of labor and delivery in China. We calculated the episiotomy rate by parity using the survey data. Associated factors of episiotomy were selected using mixed models with a random effect for the hospital-level clustering. Logistic regression models were fitted to examine the effects of mediolateral episiotomy on maternal and neonatal outcomes among the propensity score-matched women. FINDINGS: degree perineal laceration [odds ratio (OR) =2·64, 95% CI: 1·08-6·48)] in nulliparae without neonatal benefits. INTERPRETATION: degree perineal laceration in nulliparae without neonatal benefits. FUNDING: National Natural Science Foundation of China and Shanghai Health Commission Programme.