Research Article RiskFactorsforObstetricAnalSphincterInjuriesamongWomen Delivering at a Tertiary Hospital in Southwestern Uganda Mahad Ali, 1 Richard Migisha , 2 Joseph Ngonzi , 1 Joy Muhumuza, 1 Ronald Mayanja, 1 JollyJoeLapat, 1 Wasswa Salongo, 1 andMusaKayondo 1 1 Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, P.O Box 1410, Uganda 2 Department of Physiology, Mbarara University of Science and Technology, Mbarara, P.O Box 1410, Uganda Correspondence should be addressed to Richard Migisha; migisha85@gmail.com Received 10 January 2020; Accepted 28 April 2020; Published 14 May 2020 Academic Editor: Peter E. Schwartz Copyright©2020MahadAlietal.isisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background.Obstetricanalsphincterinjuries(OASIS)arisefromperinealtraumaduringvaginaldeliveryandareassociatedwith poor maternal health outcomes. Most OASIS occur in unattended deliveries in resource-limited settings. However, even in facilities where deliveries are attended by skilled personnel, a number of women still get OASIS. Objectives. To determine the incidence and risk factors for obstetric anal sphincter injuries among women delivering at Mbarara Regional Referral Hospital (MRRH). Methods.Weconductedanunmatchedhospital-basedcasecontrolstudy,withtheratioofcasestocontrolsof1:2(80 casesand160controls).Wedefinedacaseasamotherwhogotathird-orfourth-degreeperinealtearaftervaginaldeliverywhile the controls recruited were the next two mothers who delivered vaginally without a third- or fourth-degree perineal tear. A questionnaireandparticipants’medicalrecordsreviewwereusedtoobtainsociodemographicandclinicaldata.Weestimatedthe incidenceofOASISandperformedunivariableandmultivariablelogisticregressiontoidentifytheassociatedriskfactors. Results. ecumulativeincidenceforOASISduringthestudyperiodwas6.6%.eriskfactorsforOASISwere2 nd stageoflabour ≥1hour (aOR 6.07, 95%CI 1.86–19.82, p � 0.003), having episiotomy performed during labour (aOR 2.57, 95%CI 1.07–6.17, p � 0.035), perineum support during delivery (aOR 0.03, 95%CI 0.01–0.12, p < 0.001), and monthly income of >50,000 shillings (aOR 0.09, 95%CI 0.03–0.28, p < 0.001). Conclusions and Recommendations. e risk factors for obstetric anal sphincter injury were prolonged second stage of labour and performing episiotomies during deliveries while higher monthly income and perineum supportduringdeliverywereprotective.Werecommendroutinesupporttotheperineumduringdelivery.Careshouldbetakenin mothers with episiotomies, as they can extend and cause OASIS. 1.Background An obstetric anal sphincter injury (OASI) refers to third- and fourth-degree perineal tears. ird-degree tears involve a partial or complete disruption of the anal sphincter complex which includes the external anal sphincter and the internal anal sphincter. Fourth-degree tears involve dis- ruptionoftheanalmucosainadditiontodivisionoftheanal sphinctercomplex[1].Vaginaldeliveryisthemajorcauseof anal dysfunction in women. Between 0.6% and 9.0% of women, who deliver vaginally, where mediolateral episiot- omy is performed, sustain obstetric anal sphincter injuries (OASIS) [2]. A study in England found four-fold increase in the rate of reported third- or fourth-degree perineal tears, with the rate rising from 1.8% in 2000 to 5.9% in 2011 [3]. Obstetric analsphincterinjuriescausesignificantmorbidityincluding anal incontinence, rectovaginal fistula, and pain [1]. Anal incontinence is the most distressing and disabling of the OASIS complications. Anal incontinence includes a variety of symptoms including passive soiling, flatus incontinence, and incontinence of liquid or solid stool [4]. Hence, OASIS negatively impacts on women’s health by impairing their quality of life in both the short and long term. One of the mostdistressingimmediatecomplicationsofperinealinjury isperinealpain,whichcanresultintourinaryretentionand Hindawi Obstetrics and Gynecology International Volume 2020, Article ID 6035974, 7 pages https://doi.org/10.1155/2020/6035974