Severe laceration related to race, perineal length: Asian Americans have twice the risk. (Study of 34,048 Women).

LOS ANGELES -- Third and fourth-degree lacerations during delivery are more likely to happen in Asian American women and women with a shortened perineal body, two separate studies concluded.

Rates of severe laceration rates in Asian Americans were more than double those of women of other races in a retrospective analysis of 34,048 deliveries during a 7-year period, Dr. Jay Goldberg reported at the annual meeting of the American College of Obstetricians and Gynecologists.

The study included vaginal, forceps-assisted, and vacuum-assisted deliveries to 833 Asian Americans, 13,759 whites, 16,956 blacks, and 392 Hispanic Americans. Among those who did not have an episiotomy, 9% of Asians, 4% of whites, 3% of Hispanics, and 2% of black mothers suffered severe tears, said Dr. Goldberg of Jefferson Medical College, Philadelphia.

In women who had an episiotomy and in multiparous women, black race was no longer protective, and Asian race still carried an increased risk of severe tear. With an episiotomy, 32% of Asians, 19% of blacks, 17% of Hispanics, and 15% of whites developed severe lacerations.

Among 8,358 multiparous patients with or without episiotomy, the risk of severe tear was doubled in Asian women, compared with any of the other races.

Other well-known factors also increased the risk of a severe tear in a multivariate analysis. The greatest risk factor was an episiotomy, which tripled the risk for a severe tear in patients as a whole.

Among multiparous women, those with an episiotomy were seven times more likely to have a severe tear than those who did not undergo the procedure. The use of forceps tripled the risk in women overall ...