Table 5. Univariate regression model of factors associated with episiotomy

Variables Total (n=384) Episiotomy (n=208) No episiotomy (n=176) OR 95% CI p-value
BMI (mean±SD) 26.2±3.3 26.4±3.4 26.1±3.1 1 0.97–1.10 0.33
Medical history 53 (13.8) 27 (13.0) 26 (14.8) 0.61 0.48–1.54 0.09
Surgical history 32 (8.3) 20 (9.6) 12 (6.8) 1.45 0.69–3.10 0.33
Delivery history
 No 190 (49.5) 157 (75.5) 33 (18.7) Ref
 Vaginal delivery 184 (47.9) 42 (20.2) 142 (86.7) 0.06 0.04–0.10 <0.001
 Cesarean section 7 (1.8) 6 (2.9) 1 (0.6) 1.26 0.15–10.82 0.83
 Vaginal birth after caesarean 3 (0.8) 3 (1.4) 0 (0.0) 1 - -
Gestational age
 <34 weeks 3 (0.8) 3 (1.4) 0 (0.0) -
 34–37 weeks 32 (8.3) 13 (6.3) 19 (10.8) Ref
 ≥37 weeks 346 (90.1) 191 (91.8) 155 (88.1) 1.80 0.86–3.76 0.12
 Unknown 3 (0.8) 1 (0.5) 2 (1.1) 0.81 0.06–8.92 0.81
EFW (g) (mean±SD) 3,026.6±373.6 3,026.6±372.8 3,026.8±375.6 1.00 0.99–1.00 1.00
Gestational diabetes 85 (22.1) 40 (19.2) 45 (25.6) 0.69 0.43–1.12 0.14
Premature rupture of membranes 72 (18.8) 43 (20.7) 29 (16.5) 1.32 0.78–2.22 0.30
Group B Streptococcus (GBS) positive status 33 (8.6) 18 (8.7) 15 (8.5) 1.02 0.50–2.08 0.96
Gestational hypertension 11 (2.9) 9 (4.3) 2 (1.1) 3.93 0.84–18.46 0.08
Intrauterine growth restriction (IUGR) 9 (2.3) 6 (2.9) 3 (1.7) 1.71 0.42–6.95 0.45
Labor induction 37 (9.6) 21 (10.1) 16 (9.1) 1.12 0.57–2.23 0.74
Epidural analgesia 229 (59.6) 134 (64.4) 95 (54.0) 1.54 1.02–2.33 0.04
Oxytocin use in labor 78 (20.3) 50 (24.0) 28 (15.9) 1.67 1.00–2.80 0.05
Active labor duration (hours) (mean±SD) 3.3±2.4 3.7±2.4 2.7±2.2 1.23 1.11–1.35 <0.001
Perineal length (cm) (mean±SD) 4.0±0.7 4.0±0.8 3.9±0.5 1.44 1.05–1.98 0.02
Fetal heart rate monitoring
 Category I 229 (59.6) 110 (52.9) 119 (67.6) 0.52 0.34–0.80 0.003
 Category II 152 (39.6) 97 (46,6) 55 (31.3) Ref
 Not monitored 3 (0.8) 1 (0.5) 2 (1.1) 0.28 0.03–3.20 0.31
Total vaginal exams (mean±SD) 7.2±2.9 7.7±2.8 6.6±2.8 1.14 1.06–1.23 <0.001
Duration of the second stage of labor (minutes) (mean±SD) 34.5±35.6 43.4±39.0 23.9±27.7 1.02 1.01–1.03 <0.001
Birth attendants
 Midwife 122 (31.8) 48 (23.1) 74 (42.1) Ref
 Attending doctor 120 (31.3) 73 (35.1) 47 (26.7) 2.39 1.43–4.01 0.001
 Private doctor 115 (29.9) 75 (36.1) 40 (22.7) 2.89 1.70–4.90 <0.001
 Trainee 27 (7.0) 12 (5.8) 15 (8.5) 1.23 0.53–2.86 0.63
Delivery method
 Spontaneous vaginal delivery 362 (94.3) 186 (89.42) 176 (100.0) 1 - -
 Vacuum delivery 16 (4.2) 16 (7.7) 0 (0.0) - - -
 Forceps delivery 6 (1.5) 6 (2.9) 0 (0.0) - - -
Degree of perineal injury
 No injury 35 (9.1) 0 (0.0) 35 (19.9) -
 First-degree tear 124 (32.3) 5 (2.4) 119 (67.6) Ref
 Second-degree tear 225 (58.6) 203 (97.6) 22 (12.5) 219.61 81.03–595.20 <0.001
Total blood loss
 ≤200 mL 299 (77.9) 144 (69.2) 155 (88.1) Ref
 200–500 mL 79 (20.6) 59 (28.4) 20 (11.4) 3.18 1.82–5.53 <0.001
 ≥500 mL 6 (1.5) 5 (2.4) 1 (0.5) 5.38 0.62–46.62 0.13
Pain score (Wong-Baker Faces Pain Rating Scale) 24 hours postpartum 1.6±0.9 1.8±0.9 1.2±0.8 2.19 1.69–2.85 <0.001
Need for additional pain medication in postpartum departments 86 (22.4) 61 (29.3) 25 (14.2) 2.51 1.49–4.21 0.001
Perineal condition in postpartum departments
 Good recovery 287 (74.7) 134 (64.4) 153 (86.9) Ref
 Perineal swelling 89 (23.2) 67 (32.2) 22 (12.5) 3.48 2.04–5.93 <0.001
 Infection 6 (1.5) 5 (2.4) 1 (0.6) 5.71 0.66–49.48 0.11
 Wound dehiscence 2 (0.5) 2 (1.0) 0 (0.0) - - -
Length of hospital stay since delivery (days) 2.4±0.9 2.5±1.0 2.4±0.8 1.22 0.96–1.55 0.11
Apgar score 1 min≥7 375 (97.7) 201 (96.6) 174 (98.9) 0.33 0.07–1.61 0.17
Apgar score 5 min≥7 382 (99.5) 206 (99.0) 176 (100.0) - - -
Birth weight (g) 3,052.8±367.6 3,030.9±365.1 3,078.8±369.9 1.00 0.99–1.00 0.20
Head circumference 32±1.6 32.1±1.7 31.9±1.6 1.09 0.96–1.23 0.21
Neonatal admission 27 (7.0) 17 (8.17) 10 (5.7) 1.48 0.66–3.32 0.34
OR, odds ratio; CI, confidence interval; BMI, body mass index; EFW, estimated fetal weight.