Natural progression of anal incontinence after childbirth
Introduction and hypothesis The aim of work is to study the natural progression of anal incontinence (AI) in women 10 years after their first delivery and to identify risk factors associated with persistent AI. Methods A prospective cohort study of 304 primiparous women with singleton, cephalic deli...
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| Veröffentlicht in: | INTERNATIONAL UROGYNECOLOGY JOURNAL 2009-09, Vol.20 (9), p.1029-1035 |
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| creator | Nordenstam, Johan Altman, Daniel Brismar, Sophia Zetterström, Jan |
| description | Introduction and hypothesis
The aim of work is to study the natural progression of anal incontinence (AI) in women 10 years after their first delivery and to identify risk factors associated with persistent AI.
Methods
A prospective cohort study of 304 primiparous women with singleton, cephalic delivery giving vaginal childbirth in 1995. Questionnaires distributed and collected at delivery, 9 months, 5 years and 10 years after, assessing anorectal symptoms, subsequent treatment, and obstetrical events.
Results
Women, 246 of 304, answered all questionnaires (81%). Thirty-five of 246 (14%) had a sphincter tear at the first delivery. One hundred ninety-six of 246 (80%) women had additional vaginal deliveries and no caesarean sections. The prevalence of AI at 10 years after the first delivery was 57% in women with a sphincter tear and 28% in women, a nonsignificant increase compared to the 5-year follow-up. Women who sustained a sphincter tear at the first delivery had an increased risk of severe AI (RR 3.9, 95% CI 1.3–11.8). Neither age, nor subsequent deliveries added to the risk. Severe AI at baseline and 5 years after delivery were independently strong predictors of severe AI at 10 years (RR 12.6, CI 3.3–48.3, and RR 8.3, CI 3.9–17.8, respectively).
Conclusion
Persistent anal incontinence 10 years after the first parturition is frequent and sometimes severe, especially if vaginal delivery was complicated by an anal sphincter disruption. |
| doi_str_mv | 10.1007/s00192-009-0901-2 |
| format | Article |
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The aim of work is to study the natural progression of anal incontinence (AI) in women 10 years after their first delivery and to identify risk factors associated with persistent AI.
Methods
A prospective cohort study of 304 primiparous women with singleton, cephalic delivery giving vaginal childbirth in 1995. Questionnaires distributed and collected at delivery, 9 months, 5 years and 10 years after, assessing anorectal symptoms, subsequent treatment, and obstetrical events.
Results
Women, 246 of 304, answered all questionnaires (81%). Thirty-five of 246 (14%) had a sphincter tear at the first delivery. One hundred ninety-six of 246 (80%) women had additional vaginal deliveries and no caesarean sections. The prevalence of AI at 10 years after the first delivery was 57% in women with a sphincter tear and 28% in women, a nonsignificant increase compared to the 5-year follow-up. Women who sustained a sphincter tear at the first delivery had an increased risk of severe AI (RR 3.9, 95% CI 1.3–11.8). Neither age, nor subsequent deliveries added to the risk. Severe AI at baseline and 5 years after delivery were independently strong predictors of severe AI at 10 years (RR 12.6, CI 3.3–48.3, and RR 8.3, CI 3.9–17.8, respectively).
Conclusion
Persistent anal incontinence 10 years after the first parturition is frequent and sometimes severe, especially if vaginal delivery was complicated by an anal sphincter disruption.</description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-009-0901-2</identifier><identifier>PMID: 19458890</identifier><language>eng</language><publisher>London: Springer-Verlag</publisher><subject>Adult ; Anal Canal - injuries ; Cesarean section ; Delivery, Obstetric - adverse effects ; Disease Progression ; Fecal Incontinence - etiology ; Female ; Gynecology ; Health risk assessment ; Health Surveys ; Humans ; Medicine ; Medicine & Public Health ; Original Article ; Prospective Studies ; Risk ; Urology</subject><ispartof>INTERNATIONAL UROGYNECOLOGY JOURNAL, 2009-09, Vol.20 (9), p.1029-1035</ispartof><rights>The International Urogynecological Association 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-1c617181264cce8dc9f9370a5b0a500582f0a6fbe479e600bb0032ed14bf90ff3</citedby><cites>FETCH-LOGICAL-c407t-1c617181264cce8dc9f9370a5b0a500582f0a6fbe479e600bb0032ed14bf90ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00192-009-0901-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00192-009-0901-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,309,310,314,776,780,785,786,881,23909,23910,25118,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19458890$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:119195526$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Nordenstam, Johan</creatorcontrib><creatorcontrib>Altman, Daniel</creatorcontrib><creatorcontrib>Brismar, Sophia</creatorcontrib><creatorcontrib>Zetterström, Jan</creatorcontrib><title>Natural progression of anal incontinence after childbirth</title><title>INTERNATIONAL UROGYNECOLOGY JOURNAL</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J Pelvic Floor Dysfunct</addtitle><description>Introduction and hypothesis
The aim of work is to study the natural progression of anal incontinence (AI) in women 10 years after their first delivery and to identify risk factors associated with persistent AI.
Methods
A prospective cohort study of 304 primiparous women with singleton, cephalic delivery giving vaginal childbirth in 1995. Questionnaires distributed and collected at delivery, 9 months, 5 years and 10 years after, assessing anorectal symptoms, subsequent treatment, and obstetrical events.
Results
Women, 246 of 304, answered all questionnaires (81%). Thirty-five of 246 (14%) had a sphincter tear at the first delivery. One hundred ninety-six of 246 (80%) women had additional vaginal deliveries and no caesarean sections. The prevalence of AI at 10 years after the first delivery was 57% in women with a sphincter tear and 28% in women, a nonsignificant increase compared to the 5-year follow-up. Women who sustained a sphincter tear at the first delivery had an increased risk of severe AI (RR 3.9, 95% CI 1.3–11.8). Neither age, nor subsequent deliveries added to the risk. Severe AI at baseline and 5 years after delivery were independently strong predictors of severe AI at 10 years (RR 12.6, CI 3.3–48.3, and RR 8.3, CI 3.9–17.8, respectively).
Conclusion
Persistent anal incontinence 10 years after the first parturition is frequent and sometimes severe, especially if vaginal delivery was complicated by an anal sphincter disruption.</description><subject>Adult</subject><subject>Anal Canal - injuries</subject><subject>Cesarean section</subject><subject>Delivery, Obstetric - adverse effects</subject><subject>Disease Progression</subject><subject>Fecal Incontinence - etiology</subject><subject>Female</subject><subject>Gynecology</subject><subject>Health risk assessment</subject><subject>Health Surveys</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Prospective Studies</subject><subject>Risk</subject><subject>Urology</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kM1OwzAQhC0EoqXwAFxQxN2w_kliH1FFAamCC5wt27HblDYpdiLE2-MqET1xsGytZ2dnP4SuCdwRgPI-AhBJMYDEIIFgeoKmhDOGGVB2iqYgWYkZL-gEXcS4AQAOOZyjCZE8F0LCFMlX3fVBb7N9aFfBxVi3Tdb6TDepVje2bbq6cY11mfadC5ld19vK1KFbX6Izr7fRXY33DH0sHt_nz3j59vQyf1hiy6HsMLEFKYkgtODWOlFZ6VMq0LlJByAX1IMuvHG8lK4AMAaAUVcRbrwE79kM4cE3frt9b9Q-1DsdflSrazWWPtPLqTwvZSGS_nbQp42-ehc7tWn7kNaJSqQYMhecJhEZRDa0MQbn_2wJqANbNbBVia06sFWHnpvRuDc7Vx07RphJQMek6atZuXCc_L_rL6Ftg-k</recordid><startdate>20090901</startdate><enddate>20090901</enddate><creator>Nordenstam, Johan</creator><creator>Altman, Daniel</creator><creator>Brismar, Sophia</creator><creator>Zetterström, Jan</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>ADTPV</scope><scope>BNKNJ</scope></search><sort><creationdate>20090901</creationdate><title>Natural progression of anal incontinence after childbirth</title><author>Nordenstam, Johan ; Altman, Daniel ; Brismar, Sophia ; Zetterström, Jan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-1c617181264cce8dc9f9370a5b0a500582f0a6fbe479e600bb0032ed14bf90ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Anal Canal - injuries</topic><topic>Cesarean section</topic><topic>Delivery, Obstetric - adverse effects</topic><topic>Disease Progression</topic><topic>Fecal Incontinence - etiology</topic><topic>Female</topic><topic>Gynecology</topic><topic>Health risk assessment</topic><topic>Health Surveys</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Prospective Studies</topic><topic>Risk</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nordenstam, Johan</creatorcontrib><creatorcontrib>Altman, Daniel</creatorcontrib><creatorcontrib>Brismar, Sophia</creatorcontrib><creatorcontrib>Zetterström, Jan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medicine (ProQuest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>SwePub</collection><collection>SwePub Conference</collection><jtitle>INTERNATIONAL UROGYNECOLOGY JOURNAL</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nordenstam, Johan</au><au>Altman, Daniel</au><au>Brismar, Sophia</au><au>Zetterström, Jan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Natural progression of anal incontinence after childbirth</atitle><jtitle>INTERNATIONAL UROGYNECOLOGY JOURNAL</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J Pelvic Floor Dysfunct</addtitle><date>2009-09-01</date><risdate>2009</risdate><volume>20</volume><issue>9</issue><spage>1029</spage><epage>1035</epage><pages>1029-1035</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract>Introduction and hypothesis
The aim of work is to study the natural progression of anal incontinence (AI) in women 10 years after their first delivery and to identify risk factors associated with persistent AI.
Methods
A prospective cohort study of 304 primiparous women with singleton, cephalic delivery giving vaginal childbirth in 1995. Questionnaires distributed and collected at delivery, 9 months, 5 years and 10 years after, assessing anorectal symptoms, subsequent treatment, and obstetrical events.
Results
Women, 246 of 304, answered all questionnaires (81%). Thirty-five of 246 (14%) had a sphincter tear at the first delivery. One hundred ninety-six of 246 (80%) women had additional vaginal deliveries and no caesarean sections. The prevalence of AI at 10 years after the first delivery was 57% in women with a sphincter tear and 28% in women, a nonsignificant increase compared to the 5-year follow-up. Women who sustained a sphincter tear at the first delivery had an increased risk of severe AI (RR 3.9, 95% CI 1.3–11.8). Neither age, nor subsequent deliveries added to the risk. Severe AI at baseline and 5 years after delivery were independently strong predictors of severe AI at 10 years (RR 12.6, CI 3.3–48.3, and RR 8.3, CI 3.9–17.8, respectively).
Conclusion
Persistent anal incontinence 10 years after the first parturition is frequent and sometimes severe, especially if vaginal delivery was complicated by an anal sphincter disruption.</abstract><cop>London</cop><pub>Springer-Verlag</pub><pmid>19458890</pmid><doi>10.1007/s00192-009-0901-2</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Anal Canal - injuries Cesarean section Delivery, Obstetric - adverse effects Disease Progression Fecal Incontinence - etiology Female Gynecology Health risk assessment Health Surveys Humans Medicine Medicine & Public Health Original Article Prospective Studies Risk Urology |
| title | Natural progression of anal incontinence after childbirth |
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