Prevalence and predictors of episiotomy among women at first birth in Enugu, south east Nigeria

Abstract

Background: Women having their first birth have a higher risk of episiotomies. Therefore, the study of the procedure in this group of at risk women will assist in solving some of its associated controversies.
Aim: The aim was to determine the prevalence, predictors, and outcomes of episiotomy among primigravid women in Enugu, Nigeria.
Materials and Methods: The study was a retrospective cross‑sectional review of labor ward records of women that had their first delivery at the University of Nigeria Teaching Hospital (UNTH) Enugu, over a 5‑year of April 204 to March 2009. Only women that had a vaginal delivery were included in the study. Mann–Whitney U‑test (continuous data) and Chi‑square test (categorical data) were used for data analysis.
Results: Prevalence of episiotomy in the study was 62.1% (411/662). The episiotomy rate for booked women (65.6%, 376/573) was significantly higher than that of unbooked women (39.3%, 35/89), (prevalence ratio = 1.67 [95% confidence interval: 1.28, 2.17]). The birth weights of babies delivered in the episiotomy group (median = 3.2 kg [interquartile range (IQR): 2.9-3.5]) was statistically higher than those of women who did not receive episiotomy (median, 3.1 kg [IQR: 2.7-3.4]), (Z = −3.415, P = 0.001). Proportion of newborns with low 1st min Apgar scores in the episiotomy group (21.7%, 89/411) was significantly lower than the no episiotomy group (15.1%, 38/251) (P = 0.04).
Conclusion: Prevalence of episiotomy among women that had their first births in the UNTH, Enugu was high, and the predictors included booked status of women, higher gestational age at delivery, and larger neonatal birth weight. More efforts should be made to reduce episiotomy rate in the hospital.

Keywords: Episiotomy, Nullipara, Outcomes, Predictors, Primigravidae, University of Nigeria teaching hospital‑Enugu