Risk factors for clinically relevant wound complications in 442 women with second-degree perineal tears or episiotomy, using multivariable logistic regression on data from the REPAIR RCT (March–December 2023, university hospital, Denmark).
12.7% (55/433) had a wound complication; prolonged active second stage (aOR 2.25), deep tear (aOR 2.11), and doctor involvement in suturing (aOR 2.47) were associated with higher risk, while prophylactic amoxicillin-clavulanic acid was protective (aOR 0.34).
Exploratory secondary analysis of an RCT, so findings should be considered hypothesis-generating; doctor involvement in suturing likely reflects residual confounding by tear complexity rather than a causal effect; single-centre study from Denmark limits generalizability.
Women with a prolonged active second stage or a deep perineal tear are at roughly double the risk of wound complications and may benefit from targeted postpartum follow-up. Prophylactic amoxicillin-clavulanic acid at the time of repair appears protective and should be considered for high-risk cases.
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