Prevalence of anal incontinence among mothers of multiples and analysis of risk factors.
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.
Goldberg
Roger P
RP
Evanston Continence Center, Northwestern University Medical School, 1000 Central Street, Suite 730, Evanston, IL 60201, USA. rgoldberg@enh.org
Kwon
Christina
C
Gandhi
Sanjay
S
Atkuru
Laxmi V
LV
Sorensen
Mark
M
Sand
Peter K
PK
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