title: Risk factors for fecal and urinary incontinence after childbirth: the childbirth and pelvic symptoms study.
abstract: OBJECTIVE
  To identify risk factors for postpartum FI and UI.
  
  
  METHODS
  Secondary analysis of data from the CAPS study, which estimated the prevalence of postpartum FI and UI in primiparous women with clinically recognized anal sphincter tears after vaginal delivery, compared with women who delivered vaginally without recognized tears or by cesarean before labor. A total of 921 women were enrolled while in the hospital and 759 (82%) were interviewed by telephone 6 months postpartum. FI was assessed using the FISI and UI using the Medical, Epidemiological, and Social Aspects of Aging Questionnaire. FI risk factor analyses were conducted within each group, because of higher prevalence in the tear group. UI analyses were conducted with the groups combined.
  
  
  RESULTS
  In women with sphincter tears, FI at 6 months was associated with white race (OR 6.1, 95% CI 1.3-29.4), antenatal UI (OR 2.2, CI 1.1-4.3), 4th versus 3rd degree tear (OR 2.0, CI 1.0-4.0), older age at delivery (OR 1.6 per 5 yr, CI 1.2-2.1), and higher body mass index (BMI) (OR 1.3 per 5 kg/m(2), CI 1.0-1.7). No factors were associated with FI in the vaginal or cesarean control groups. Across all groups, risk factors for postpartum UI were antenatal UI (OR 3.5, CI 2.4-5.2), less education (OR 2.0, CI 1.4-2.8), and higher BMI (OR 1.2 per 5 kg/m(2), CI 1.1-1.4); cesarean delivery was protective (OR 0.5, CI 0.3-0.9).
  
  
  CONCLUSIONS
  Postpartum FI and UI are associated with few modifiable risk factors. However, the presence of antenatal UI and high BMI may help clinicians target at-risk women for early intervention.
authors.affiliation: University of Alabama at Birmingham, Birmingham, Alabama, and Birmingham VA Medical Center, Birmingham, Alabama 35233, USA.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Burgio
authors.forename: Diane
authors.initials: D
authors.lastname: Borello-France
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
authors.forename: Mary Pat
authors.initials: MP
authors.lastname: Fitzgerald
authors.forename: William
authors.initials: W
authors.lastname: Whitehead
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Handa
authors.forename: Ingrid
authors.initials: I
authors.lastname: Nygaard
authors.forename: Paul
authors.initials: P
authors.lastname: Fine
authors.forename: Halina
authors.initials: H
authors.lastname: Zyczynski
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Visco
authors.forename: Morton B
authors.initials: MB
authors.lastname: Brown
authors.forename: Anne M
authors.initials: AM
authors.lastname: Weber
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D015992:Body Mass Index; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004841:Episiotomy; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011644:Puerperal Disorders / Q000209:etiology*; D012307:Risk Factors; D014549:Urinary Incontinence / Q000209:etiology*