Anal incontinence after childbirth: incidence in the Korean population

To investigate the incidence and risk factors for anal incontinence after childbirth in Korea.

We retrospectively examined the records of 1,123 unselected women who delivered live infants at the KyungHee University Hospital between January 2006 and December 2006. Symptoms of anal incontinence were assessed by telephone interview using standard questionnaires.

A total of 966 women (86%) responded to the survey, and the overall incidence of anal incontinence was 6.1% (9 fecal and flatal incontinence, 50 flatal incontinence). Of the study population, 562 (58.2%) had vaginal deliveries and 404 (41.8%) had cesarean sections. Vacuum extraction was used in 160 (28.5%) cases, and sphincter tears occurred in 16 (2.8%). Multivariate analysis showed that anal incontinence was associated with multiparity [2.75 (1.17-6.47)], maternal weight increase >or=15 kg [2.11 (1.03-4.31)], vaginal delivery with vacuum extraction [2.74 (1.23-6.14)], sphincter laceration [14.74 (4.69-46.27)], and cesarean section after second-stage labor [16.82 (4.61-61.40)].

Koreans had a lower incidence of post-birth anal incontinence than Westerners (6.1 and 29.3%, respectively), even though the risk factors were similar. These findings suggest that further studies examining differences in the incidence of anal incontinence based on ethnicity are warranted as such information may provide clues in terms of prevention and management of this disorder.