The association between striae gravidarum and perineal lacerations during labor

by Tamar Matyashov, Ella Pardo, Reut Rotem, Yael Lichtman, Maayan Elnir Katz, Adi Y. Weintraub, Amir Horev

Striae gravidarum (SG) and perineal lacerations are common occurrences during late pregnancy and labor. It has been hypothesized that both conditions may share a common pathophysiological pathway through changes in the connective tissue. We aimed to investigate a possible association between these two conditions and whether the presence of SG may predict perineal lacerations.

We conducted a prospective cohort study that included women who gave birth at the Soroka University Medical Center (SUMC), Beer-Sheva, Israel. Those who provided informed consent were examined for the presence of SG using the Davey scoring system to determine the severity of abdominal SG. Clinical and obstetrical characteristics and the presence and degree of perineal tears were retrieved from the computerized patients’ records. Univariate analysis was carried using appropriate statistical tests.

A total of 187 women were recruited. Of those, 81 (43.3%) did not have SG, 24 (12.8%) 43 (23%) and 39 (20.9%) had mild, moderate and severe SG, respectively. Women with SG were significantly older and had a higher body mass index (p<0.01 for both). Delivery characteristics, mode of delivery, and gestational age were comparable between the groups; however, women with SG gave birth to significantly larger neonates (p<0.01). Seventy-one (31%) women had suffered from 1^st or 2^nd-degree perineal tears, and none had 3^rd or 4^th-degree perineal tears. No significant differences were found in rates of perineal tears between women with and without SG (p = 0.91), regardless of SG severity (p = 0.38).

In our study, SG was not associated with perineal tears. This information may be used as reassurance when giving antepartum consultation to women with SG, even in severe cases.