title: Prevalence and predictors of urinary/anal incontinence after vaginal delivery: prospective study of Nigerian women.
abstract: OBJECTIVE
  Urinary and anal incontinence are major public health problems impacting on the quality of life of affected women, with resultant loss of self-esteem. Despite the anticipated magnitude of this public health problem in sub-Saharan Africa, there is paucity of data on the prevalence of urinary and/or anal incontinence after childbirth in the region. This study determined the prevalence and predictors of urinary and anal incontinence after vaginal delivery among women in Enugu, southeastern Nigeria.
  
  
  METHODS
  This was a longitudinal study of 230 consecutive parturients at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Eligible women were followed up immediately, 6 weeks, and 3 months postpartum to assess the development of urinary and/or anal incontinence using validated questionnaires.
  
  
  RESULTS
  Overall, 28 women had urinary incontinence, giving a cumulative prevalence rate of 12.2 %. The cumulative prevalence rate was 13.5 % for anal incontinence and 3 % for combined urinary and anal incontinence. Age, social class, parity, prolonged second stage of labor, and neonatal birth weight were significantly associated with postpartum urinary incontinence (P < 0.05). On the other hand, age, parity, prolonged second stage of labor, episiotomy, and instrumental vaginal delivery were significantly associated with postpartum anal incontinence (P < 0.05).
  
  
  CONCLUSIONS
  Urinary and anal incontinence are common after vaginal delivery in Enugu, Nigeria. Modification of obstetric care and discouraging preventable predisposing factors for incontinence, such as prolonged second stage of labor and vaginal delivery of macrosomic babies, are measures that may reduce the prevalence of postpartum incontinence in our population.
authors.affiliation: Department of Obstetrics/Gynaecology, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria.
authors.forename: Kingsley Chukwu
authors.initials: KC
authors.lastname: Obioha
authors.forename: Emmanuel Onyebuchi
authors.initials: EO
authors.lastname: Ugwu
authors.forename: Samuel Nnamdi
authors.initials: SN
authors.lastname: Obi
authors.forename: Cyril Chukwudi
authors.initials: CC
authors.lastname: Dim
authors.forename: Theophilus Chimezie
authors.initials: TC
authors.lastname: Oguanuo
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult