title: Prevalence and risk factors for urinary and fecal incontinence four months after vaginal delivery.
abstract: OBJECTIVE
  To determine the prevalence of and risk factors for urinary and fecal incontinence four months after vaginal delivery.
  
  
  METHODS
  All patients who had vaginal deliveries at a tertiary care hospital over a three-month period were approached during their postpartum hospital stay regarding participation in the study. Participants underwent a telephone interview at four months after their delivery to determine the presence and type of any incontinence.
  
  
  RESULTS
  Of 632 patients, 145 (23%) had stress incontinence, 77 (12%) had urge incontinence, 181 (29%) had any urinary incontinence and 23 (4%) had fecal incontinence. In univariate analysis, stress incontinence was found to be increased in patients>or=30 years of age (26.2%) compared with patients<30 years of age (19.3%) (RR 1.4; 95% CI 1.0-1.8, P=0.05). Urge incontinence was increased in patients who had a forceps delivery (21%) compared with no forceps delivery (9%) (RR 2.2; 95% CI 1.4-3.6, P=0.005), an episiotomy (32.4%) compared with no episiotomy (18.7%) (RR 1.9; 95% CI 1.2-2.9, P<0.01) and a longer second stage of labour (108 min vs. 77 min, P=0.01). The prevalence of any urinary incontinence was increased with forceps delivery (15.5%) compared with no forceps delivery (8.7%) (RR 1.5; 95% CI 1.1-2.1, P=0.01) and maternal age of >or=30 years (34.1%) compared to <30 years (23.5%) (RR 1.5; 95% CI 1.1-1.9, P=0.003). In multivariate analysis, the two variables that remained significant for any urinary incontinence were maternal age>or=30 years (P<0.01) and forceps delivery (P<0.01). There were no identified risk factors for fecal incontinence.
  
  
  CONCLUSIONS
  Urinary incontinence is common in women at four months post partum. Fecal incontinence is less common. Maternal age and forceps assisted delivery were risk factors for urinary incontinence.
authors.affiliation: Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Baydock
authors.forename: Catherine
authors.initials: C
authors.lastname: Flood
authors.forename: Jane A
authors.initials: JA
authors.lastname: Schulz
authors.forename: Dianna
authors.initials: D
authors.lastname: MacDonald
authors.forename: Deborah
authors.initials: D
authors.lastname: Esau
authors.forename: Sandra
authors.initials: S
authors.lastname: Jones
authors.forename: Craig B
authors.initials: CB
authors.lastname: Hiltz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D016001:Confidence Intervals; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D009772:Obstetrical Forceps / Q000009:adverse effects*; D016017:Odds Ratio; D036801:Parturition; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology*; D055815:Young Adult