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Anal incontinence after childbirth
Erica Eason1, Michel Labrecque, Sylvie Marcoux
1Department of Obstetrics and Gynecology, University of Ottawa, Ont. eeason@ohri.ca
Summary
Childbirth can lead to fecal incontinence, with 3.1% of women reporting stool incontinence and 25.5% reporting flatus incontinence three months postpartum. Forceps delivery and anal sphincter tears are key risk factors for these issues.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Disorders
- Postpartum Complications
Background:
- Childbirth is a significant risk factor for developing fecal and flatus incontinence.
- These conditions represent frequent and impactful complications following delivery.
Purpose of the Study:
- To investigate the prevalence of stool and flatus incontinence in a large cohort of women post-childbirth.
- To identify potential causes and risk factors associated with these incontinence issues.
Main Methods:
- A cohort of 949 women who gave birth were studied.
- Participants completed a self-administered questionnaire three months after delivery.
- Data were collected from women involved in a randomized controlled trial of prenatal perineal massage.
Main Results:
- Three months postpartum, 3.1% of women reported stool incontinence and 25.5% reported flatus incontinence.
- Forceps delivery and anal sphincter tears were identified as independent risk factors for incontinence.
- Anal sphincter injury was strongly associated with first vaginal birth, episiotomy, and operative vaginal delivery (forceps or vacuum).
Conclusions:
- Forceps delivery and anal sphincter lacerations are linked to anal incontinence.
- First vaginal birth, median episiotomy, and operative vaginal delivery are strong predictors of anal sphincter laceration.
- Birth weight and the length of the second stage of labor were not significant predictors of anal sphincter injury.