title: Defecatory symptoms during and after the first pregnancy: prevalences and associated factors.
abstract: A prospective cohort study was undertaken to evaluate the impact of pregnancy and the first delivery on the defecatory symptoms and to identify associated factors. Included were 487 nulliparous pregnant women who completed four questionnaires. Flatus and fecal incontinence, constipation, and painful defecation are already present in early pregnancy and are significantly predictive for reporting symptoms after delivery, except for fecal incontinence. A third or fourth degree sphincter tear was significantly associated with fecal incontinence 12 months postpartum and with de novo fecal incontinence, while other factors associated with de novo onset of symptoms were of borderline significance. Defecation symptoms already present in early pregnancy are highly predictive for reported symptoms at 12 months postpartum except for fecal incontinence that is mainly related to anal sphincter lesion. Therefore, investigating the effects of childbirth in general on the anorectal function is not justified without knowledge of this function during pregnancy.
authors.affiliation: Department of Perinatology and Gynecology, University Medical Center Utrecht, Room F05.216, Heidelberglaan 100, 85500, 3508, Utrecht, The Netherlands. hbrummen@zonnet.nl
authors.forename: H Jorien
authors.initials: HJ
authors.lastname: van Brummen
authors.forename: Hein W
authors.initials: HW
authors.lastname: Bruinse
authors.forename: Geerte
authors.initials: G
authors.lastname: van de Pol
authors.forename: A Peter M
authors.initials: AP
authors.lastname: Heintz
authors.forename: C Huub
authors.initials: CH
authors.lastname: van der Vaart
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries; D001724:Birth Weight; D015331:Cohort Studies; D003248:Constipation / Q000209:etiology*; D003672:Defecation / Q000502:physiology*; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D005414:Flatulence / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D010298:Parity; D036801:Parturition; D011247:Pregnancy; D011248:Pregnancy Complications; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000209:etiology*; D015430:Weight Gain / Q000502:physiology