Prediction of Perineal Trauma During Childbirth by Assessment of Striae Gravidarum Score


Ofra Halperin, PhD, Faculty of Nursing, The Max Stern Academic College of Emek Yezreel, Bnei-Zion Nursing School, Haifa 19300, Israel.


Objective: To explore the association between striae gravidarum (SG) and the risk for perineal trauma (PT) in childbirth.

Design: A cross-sectional study.

Setting: Maternity ward in 5 university medical centers.

Participants: Three hundred and eighty-five women (28.9±5.3 years old) who delivered vaginally.

Methods: Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between PT as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) obtained at the abdomen, hips, buttocks, and breast.

Results: Significantly higher TSS scores were found in women with PT compared with women without PT (3.60±0.39 vs. 2.31±0.23, p=.003). Specifically, striae scores at the breast and hips were significantly higher among women who had PT. Logistic regression analysis revealed that TSS (OR=0.079; 95% CI 1.012, 1.151; p=.021), as well as a rise in body mass index (BMI) during pregnancy (OR=1.025; 95% CI 1.001, 1.049; p=.043) are significant predictors of PT.

Conclusions: This study demonstrates a significant relation between SG and PT. The findings suggest that SG assessment may be used in the clinical setting by midwives and nurses as a simple and noninvasive tool to better define women at risk for PT.