Anne Weng Ekmann-Gade*, Jens Anton Svare, Bent Brandt Hansen and Gunnar Lose
Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, DenmarkFulltext PDF
Objectives: The aim of this study was to examine maternal and perinatal risk factors for anal incontinence (AI) one year after vaginal delivery in primiparous women with no AI before the pregnancy.
Methods: We performed a prospective questionnaire cohort survey, dealing with 571 primiparous women. The women completed a validated questionnaire assessing symptoms of AI after delivery and one year later. AI was defined as any episode of either flatus incontinence and/or incontinence for liquid stools and/or incontinence for solid stools. Univariate and multivariate logistic regression analyses were conducted.
Results: In univariate analyses, postpartum AI was significantly associated with AI during pregnancy (p < 0.01), obstetric anal sphincter injuries (OASIS) (p = 0.01), maternal lateral birth position (p = 0.02) and duration of stages one and two ≥ eight hours (p = 0.03). The association between AI and head circumference ≥ 38 cm was of borderline significance (p = 0.05). Logistic regression analysis confirmed that postpartum AI was associated with AI during pregnancy (odds ratio (OR) 2.8, 95% confidence interval (CI); 1.8-4.2), OASIS (OR 2.7, 95% CI; 1.3-5.6), head circumference ≥ 38 cm (OR 2.8, 95% CI; 1.1-7.3) and duration of stages one and two ≥ eight hours (OR 1.6, 95% CI; 1.0-2.4).
Conclusion: In this population of Danish primiparous women without AI before pregnancy, the study found that AI one year after delivery was significantly associated with AI during pregnancy, OASIS, duration of stage one and two ≥ eight hours and head circumference ≥ 38 cm.
Postpartum anal incontinence; Pregnancy; Primiparous; Risk factors; Vaginal delivery
Ekmann-Gade AW, Svare JA, Hansen BB, Lose G. Risk Factors for the Symptom of Anal Incontinence One Year after Vaginal Delivery in Primiparous Danish Women: A Prospective Cohort Study. Ann Gynecol Obstetr Res. 2018; 1(1): 1005.