title: Prevalence of anal incontinence among mothers of multiples and analysis of risk factors.
abstract: OBJECTIVE
  The object of this study was to determine the prevalence of anal incontinence among women with previous multiple pregnancy and childbirth and assess risk factors.
  
  
  METHODS
  A 77-item questionnaire was administered to 769 mothers of multiples. Statistical analyses included chi(2), Student t test, and logistic regression.
  
  
  RESULTS
  Seven hundred thirty-three (95.3%) women completed the survey, 94% of them white, with a median age of 37 years. Fecal incontinence affected 10% (6.3% arose during pregnancy, 40.6% after delivery, 53.1% unrelated to childbirth). Although delivery by cesarean section only was associated with lower prevalence in univariate analysis (5.8% vs 11%, P=.02), age was the only significant covariate in multivariate regression (P=.0001). Flatal incontinence affected 25.2% (21.2% during pregnancy, 30.3% after delivery, 48.5% unrelated), increasing with age (P=.0001). Soiling affected 10%, increasing with age (P=.0001).
  
  
  CONCLUSIONS
  Mothers of multiples reported substantial rates of fecal (10%) and flatal (25.2%) incontinence. Advancing age was the major risk factor. Delivery by cesarean section only was not significantly protective, although elective (before labor) cesarean deliveries were not separately assessed.
authors.affiliation: Evanston Continence Center, Northwestern University Medical School, 1000 Central Street, Suite 730, Evanston, IL 60201, USA. rgoldberg@enh.org
authors.forename: Roger P
authors.initials: RP
authors.lastname: Goldberg
authors.forename: Christina
authors.initials: C
authors.lastname: Kwon
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gandhi
authors.forename: Laxmi V
authors.initials: LV
authors.lastname: Atkuru
authors.forename: Mark
authors.initials: M
authors.lastname: Sorensen
authors.forename: Peter K
authors.initials: PK
authors.lastname: Sand
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D011247:Pregnancy; D011272:Pregnancy, Multiple; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014310:Triplets; D014427:Twins