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TOPLINE
Women with vulvar lichen sclerosus (VLS) had a higher risk for second-degree tears and obstetric anal sphincter injuries during vaginal delivery than those without the condition.
METHODOLOGY
- Researchers conducted a retrospective cohort study to assess whether women with VLS had a higher risk for perineal tears during vaginal birth than those without the condition.
- They reviewed records of births in the North Denmark Region between October 2019 and September 2024, including each birth by a woman with VLS and the next two births by women without VLS.
- Tear outcomes were analyzed in 224 vaginal births among women with VLS and 441 vaginal births among those without VLS.
- Perineal tears were graded as superficial (no sutures needed), first-degree, second-degree, or obstetric anal sphincter injury.
TAKEAWAY
- Among the vaginal births in women with VLS, 12 involved obstetric anal sphincter injuries.
- After adjusting for relevant factors, women with VLS had a 1.32-fold higher risk for second-degree perineal tears and a 3.37-fold higher risk for obstetric anal sphincter injury during vaginal birth than those without the condition (P = .006 and P = .01, respectively).
- Among women with VLS, risk factors for obstetric anal sphincter injury included first birth (4.91-fold), vacuum-assisted delivery (6.50-fold), narrowing of the vaginal opening before pregnancy (6.20-fold), and symptoms in pregnancy such as itching and/or skin fragility (3.98-fold; P < .05 for all).
IN PRACTICE
"[The] study emphasizes the importance of adequate and continuous treatment of VLS both before and throughout pregnancy as disease control may help reduce the risk of obstetric perineal trauma," the researchers wrote.
SOURCE
The study was led by Cecilie Hagen Andersen of North Denmark Regional Hospital in Hjørring, Denmark. It was published online on October 7 in the American Journal of Obstetrics and Gynecology.
LIMITATIONS
Details regarding mode of earlier deliveries were missing. Records were reviewed retrospectively, so treatment and disease control before birth could not be checked properly.
DISCLOSURES
Funding information was not provided for the study. The authors did not report any conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
