[Factors associated with fecal incontinence after childbirth. Prospective study in 525 women].
OBJECTIVE
To determine the prevalence of fecal incontinence after childbirth and to identify the risk factors.


METHODS
This was a prospective observational study with a consecutive inclusion of 525 women who delivered over a three months period. Women were questioned about their fecal continence four days and six weeks after delivery.


RESULTS
The incidence of fecal incontinence four days and six weeks after childbirth was respectively 8.8% and 3.3%. The risk factors for fecal incontinence at 4 days after childbirth were instrumental delivery by forceps (adjusted odds ratio 8.64, 95% confidence interval 3.55-21.0, p < 0.001) and unassisted delivery at home (adjusted OR 8.06, 95% CI 1.30-50.0, p = 0.025). Independent risk factors for the presence of fecal incontinence 6 weeks later were: instrumental forceps delivery (adjusted OR 10.8, 95% CI 2.82-41.3, p = 0.001), unassisted delivery at home (adjusted OR 50.0, 95% CI 3.09-802, p = 0.006), bi-parietal diameter of the newborn > 93 mm (adjusted OR 4.56, 95% CI 1.46-14.1, p = 0.009) and maternal age >30 years (adjusted OR 4.60, 95% CI 1.11-19.1, p = 0.036).


CONCLUSIONS
Fecal incontinence is common after childbirth and its prevalence is predominantly associated with instrumental delivery, unassisted delivery at home, bi-parietal diameter of the newborn and maternal age.
Roman
H
H
Service de Gynécologie et Obstétrique, Groupe Hospitalier Sud Réunion, 97448 Saint-Pierre, Ile de la Réunion, France. horace.roman@libertysurf.fr
Robillard
P-Y
PY
Payet
E
E
El Amrani
R
R
Verspyck
E
E
Marpeau
L
L
Barau
G
G
D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006700:Home Childbirth / Q000009:adverse effects / Q000379:methods; D006801:Humans; D015994:Incidence; D008423:Maternal Age; D007744:Obstetric Labor Complications; D009772:Obstetrical Forceps / Q000009:adverse effects; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors