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Table 4 Association between mediolateral episiotomy and the condition of infant at birth (pH umbilical artery < 7.10, 5-min Apgar score < 7) according to the type of operative vaginal delivery and fetal distress status (2013–2017)

From: Mediolateral episiotomy and risk of obstetric anal sphincter injuries and adverse neonatal outcomes during operative vaginal delivery in nulliparous women: a propensity-score analysis

  Total number Mediolateral episiotomy No Mediolateral episiotomy RR (95% CI)
  n pH umbilical artery < 7.10
or 5-min Apgar score < 7,
n (%)
n pH umbilical artery < 7.10
or 5-min Apgar score < 7,
n (%)
Univariate
analysis *
Using IPTW *
Forceps/spatula delivery
 Fetal distress 453 257 7 (4.2) 288 39 (13.5) 0.40 (0.16–0.98) 0.52 (0.31–0.89)
 No fetal distress 688 274 13 (3.6) 414 23 (5.6) 0.80 (0.37–1.74) 0.70 (0.41–1.20)
Vacuum delivery
 Fetal distress 1008 228 21 (9.2) 780 112 (14.4) 0.83 (0.51–1.36) 0.89 (0.68–1.17)
 No fetal distress 1434 298 14 (4.7) 1136 71 (6.3) 0.81 (0.45–1.47) 1.06 (0.77–1.48)
  1. RR risk ratio, CIs confidence intervals, IPTW inverse probability of treatment weighting. * Mixed model after multiple imputation of missing data. Missing data – mode of operative vaginal deliveries: n = 25. Covariates used to estimate the propensity score: maternal age, smoking, Body mass index, gestational diabetes, hypertension disorders in pregnancy, induction of labour, epidural analgesia, occiput posterior position, prolonged pregnancy, type of instruments (forceps/ spatula delivery and vacuum delivery), small for gestational age, year of delivery and level of maternity unit