Incidence Rate and Risk Factors of Genital Tract Trauma after Vaginal Delivery: A Hospital-based Study

Background and Objectives: Genital tract trauma is a common complication of vaginal delivery, with significant implications for maternal health. This study aimed to estimate the incidence of genital tract trauma and evaluate associated risk factors among women who delivered vaginally at a tertiary hospital in Erbil, Kurdistan Region of Iraq. Methods: A hospital-based cross-sectional case-control study was conducted over one year, from January 2023 to January 2024 at Maternity Teaching Hospital in Erbil city, Iraq. Women who delivered vaginally were selected through consecutive sampling, and a structured questionnaire collected data on demographics, obstetric factors, and neonatal outcomes. Inferential statistics, including chi-square tests and logistic regression, were applied to identify significant risk factors for genital tract trauma. Results: The incidence of genital tract trauma was 2.63% (n=330). Key risk factors included primiparity (66%, p<0.05), urban residence (70.3%, p<0.05), and labor induction with oxytocin (42.4%, p<0.05). Macrosomia was the most common cause of trauma (36.1%). Neonatal outcomes were significantly worse among cases, with 4.5% fetal stillbirth (p<0.05) and 19.4% admissions to the intensive care unit (p<0.05). The most frequent injuries were first-degree perineal tears (34.5%), followed by vulval lacerations (23.9%) and paraurethral tears (15.5%). Conclusion: Genital tract trauma remains a significant complication of vaginal delivery, particularly among primiparous women and those with labor induction. Preventive strategies targeting modifiable risk factors, such as labor management and macrosomia prevention, could reduce the incidence of trauma and improve maternal and neonatal outcomes.