The Relationship between Perineal Trauma and Striae Gravidarum: A Systematic Review and Meta Analysis

Fatemeh Khademolkhamseh, Samira Ebrahimzadeh Zagami, Vahid Ghavami



Background: Perineal trauma is a common problem seen after vaginal delivery, which has negative effects on different aspects of women’s lives. Poor skin elasticity has been introduced as a predictor of perineal trauma, and the appearance of striae gravidarum is associated with poor skin elasticity. This review aimed to determine the association between perineal trauma and striae gravidarum through a systematic review and meta‑analysis.

Materials and Methods: We searched with MeSH terms (“Perineum” AND “Lacerations” OR “Rupture” AND “Striae Distensae”) and their equivalents in databases PubMed, Scopus, Science direct, Web of Science, ProQuest, Scientific Information Database (SID), Magiran, and Google Scholar search engine without time and language restrictions from the beginning of May until the beginning of September 2020. After reviewing the inclusion and exclusion criteria, and quality evaluation, ten articles were included in the systematic review, and we analyzed data of 6 articles using Stata ver 11.2.

Results: The results indicated that the rate and severity of perineal trauma were directly related to the severity of striae gravidarum (OR = 8.28, 95%CI = 2.49–27.54, I² = 86.64%).

Conclusions: Based on the research results, the probability of perineal trauma was higher in individuals with moderate to severe striae than those with mild or without striae; therefore, we suggest evaluating striae score in the third trimester of pregnancy as a simple and noninvasive method to predict the risk of perineal trauma during childbirth. For reducing perineal injuries in women at risk, some supportive measures such as episiotomy and perineal massage are recommended.


Delivery, meta‑analysis, perineum, striae distensae

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