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\begin{document}

\title{Obstetric anal sphincter injury by maternal origin and length of
residence: a nation-wide cohort study}



\author[1]{Ingvil Sorbye}%
\author[1]{Sukhjeet Bains}%
\author[1]{Siri Vangen}%
\author[2]{Johanne Sundby}%
\author[3]{Benedikte  Lindskog }%
\author[4]{Katrine Owe}%
\affil[1]{Oslo University Hospital}%
\affil[2]{University of Oslo Faculty of Medicine}%
\affil[3]{Oslo Metropolitan University}%
\affil[4]{Norwegian Institute of Public Health}%


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  \date{May 20, 2024}


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\begin{abstract}
Objective: To estimate the association between maternal origin and
obstetric anal sphincter injury (OASI), and assess if associations
differed by length of residence. Design: Population-based cohort study.
Setting: The Medical Birth Registry of Norway. Population: Primiparous
women with vaginal livebirth of a singleton cephalic fetus between 2008
and 2017 (n=188 658). Methods: Multivariable logistic regression models
estimated aORs for OASI with 95\% CI by maternal region of origin and
birthplace. We stratified models on length of residence and paternal
birthplace. Main outcome measures: OASI. Results: Overall 6 373 cases of
OASI were identified (3.4\% of total cohort). Women from South Asia were
most likely to experience OASI (6.2\%; aOR 2.24, 95\% CI 1.93--2.60),
followed by those from Southeast/East Asian/Pacific (5.7\%; 1.83,
1.64--2.04), and Sub-Saharan Africa (5.2\%; 1.97, 1.72--2.26), compared
to women originating from Norway. Among women born in the same region,
those with short length of residence in Norway (0--4 years), showed
higher odds of OASI. Migrant women across most regions of origin had
reduced risk of OASI if they had a Norwegian compared to foreign-born
partner. Conclusions: Primiparous women from Asian regions and
Sub-Saharan Africa had up to two-fold risk of OASI, compared to women
originating from Norway. Migrants with short residence and those with a
foreign-born partner had higher risk of OASI, implying that some of the
risk differential is due to sociocultural factors. Some migrants,
especially new arrivals, may benefit from special attention during
labour to reduce morbidity and achieve equitable outcomes.%
\end{abstract}%



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