RT Journal Article T1 Risk Factors in Third and Fourth Degree Perineal Tears in Women in a Tertiary Centre: An Observational Ambispective Cohort Study A1 Barca Sánchez, Juan Antonio A1 Bravo Arribas, Coral A1 Pintado Recarte, María Del Pilar A1 Cueto Hernández, Ignacio A1 Ruiz Labarta, Javier A1 Cuñarro López, Yolanda A1 Bujan, Julia A1 Álvarez Mon, Melchor A1 Ortega, Miguel Angel A1 De León Luis, Juan Antonio AB Objectives: To analyze the main risk factors associated with third and fourth degree postpartum perineal tears in women attended to in our obstetrics service. Methods: An observational, retrospective, hospital cohort study was carried out in women whose deliveries were attended to in the obstetrics service of the Hospital General Universitario Gregorio Marañón de Madrid (HGUGM), during the period from January 2010 to April 2017. Results: During the study period, a total of 33,026 patients were included in the study. For maternal variables, the associated increased risk of severe perineal tearing in nulliparous women is OR = 3.48, for induced labor OR = 1.29, and for instrumental delivery by forceps OR = 4.52 or spatulas OR = 4.35; for the obstetric variable of episiotomy, it is OR = 3.41. For the neonatal variables, the weight of the newborns has a directly proportional relationship with the risk of severe tears, and for birth weights of 3000 g (OR = 2.41), 3500 g (OR = 1.97), and 4000 g (OR = 2.17), statistically significant differences were found in each of the groups (p < 0.05). Conclusion: Primiparity, induction of labor, episiotomy, instrumental delivery with forceps or spatula, and a birth weight of 3000 g or more are significantly associated with an increased risk of third and fourth degree perineal tears. PB MDPI SN 2075-4426 YR 2021 FD 2021-07-21 LK https://hdl.handle.net/20.500.14352/5041 UL https://hdl.handle.net/20.500.14352/5041 LA eng NO Barca, J.A.; Bravo, C.; Pintado-Recarte, M.P.; Cueto-Hernández, I.; Ruiz-Labarta, J.; Cuñarro, Y.; Buján, J.; Alvarez-Mon, M.; Ortega, M.A.; De León-Luis, J.A. Risk Factors in Third and Fourth Degree Perineal Tears in Women in a Tertiary Centre: An Observational Ambispective Cohort Study. JPM 2021, 11, 685, doi:10.3390/jpm11080685. NO This study (FIS-PI18/00912) was supported by the Instituto de Salud Carlos III (Plan Estatal de I+D+i 2013–2016) and co-financed by the European Regional Development Fund “A Road to Europe” (ERDF), as well as B2017/BMD-3804 MITIC-CM and Halekulani S.L. NO Unión Europea NO Comunidad de Madrid NO Instituto de Salud Carlos III NO Halekulani S.L. DS Docta Complutense RD 10 abr 2025