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Does cesarean protect against fecal incontinence in primiparous women?

Jeanne-Marie Guise1, Sarah Hamilton Boyles, Patricia Osterweil

  • 1Department of OB/GYN, Oregon Health & Science University, Portland, OR, USA. guisej@ohsu.edu

International Urogynecology Journal and Pelvic Floor Dysfunction
|October 25, 2008
PubMed

The objective of this study was to identify factors associated with new onset of postpartum fecal incontinence in primiparous women. A population-based study was conducted that surveyed all women delivering between 2002 and 2003 in Oregon. Factors associated with fecal incontinence were identified using logistic regression analysis. A total of 6,152 primiparous women completed the survey 3-6 months postpartum with 2,482 reporting a new onset of fecal incontinence (FI) after childbirth. Vaginal delivery was associated with a greater risk of FI compared to cesarean (odds ratio = 1.45; 95% confidence interval, 1.29 to 1.64). However, vaginal delivery without laceration or instrument assistance did not increase the risk of FI over cesarean. Being overweight (body mass index >/=30 kg/m(2)), pushing for greater than 2 h, and constipation were independently associated with postpartum FI (p < 0.05) regardless of route of delivery. This study provides important data to inform counseling and management of primiparous women.

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