Effects of delivery mode on postpartum fecal incontinence and urinary incontinence in Chinese women

Abstract

Objective To investigate the prevalence and associated factors of fecal incontinence (FI) and urinary incontinence (UI) in postpartum Chinese women.Methods Questionnaires about FI and UI symptoms were completed via telephone interviews conducted within six months after delivery.Multi-variant Logistic analysis was applied for relation between delivery mode and FI or UI.Results (1) Two thousand and twelve postpartum women were admitted into this study,among which 14 (0.7％) had FI within 6 months after delivery.Logistic regression analysis showed that FI was significantly associated with forceps delivery (OR =20.09,95 ％ CI:3.64-110.90,P =0.000),and mediolateral episiotomy (OR=6.11,95％ CI:1.29-28.80,P=0.024).(2) Among the 2012 women,the prevalence of UI,stress urinary incontinence (SUI),urgent urinary incontinence (UUI)and mixed urinary incontinence (MUD was 10.04％ (n=202),8.15％ (n=164),0.94％ (n=19)and 0.94 ％ (n =19),respectively.Logistic regression analysis found that SUI prevalence was related to maternal age (OR =1.07,95％ CI:1.04-1.11,P =0.000),maternal weight before delivery (OR=1.04,95％ CI:1.02-1.06,P=0.001),neonatal head circumference (OR=1.20,95％ CI:1.05-1.39,P =0.010),mediolateral episiotomy (OR =4.96,95 ％ CI:3.05-8.07,P =0.0005 ),spontaneous vaginal delivery (OR=5.22,95％ CI:2.53-10.76,P=0.000) and forceps delivery (OR=9.20,95％ CI:4.07-20.79,P=0.000).UUI was related to maternal weight before delivery (OR=1.51,95％ CI:1.12-2.05,P=0.008).MUI was related to maternal weight before delivery (OR=1.06,95％ CI:1.00-1.11,P=0.049),duration of second stage of labor (OR=1.01,95％ CI:1.00-1.03,P =0.010),mediolateral episiotomy (OR =7.76,95％ CI:1.42-42.52,P=0.017) and forceps delivery (OR=15.21,95％ CI:1.61-143.44,P=0.018).(3) The prevalence of SUI was higher at 4 days and 42 days after delivery (7.95％ and 9.10％).Conclusions (1) F1 and UI prevalence is lower in this study than in other reports.(2) Vaginal delivery is a risk factor for women's FI and UI,especially forceps delivery and mediolateral episiotomy.(3) Maternal age,pre-delivery weight,newborn head circumference,spontaneous vaginal delivery,forceps delivery and mediolateral episiotomy might increase the risk of UI. Key words: Fecal incontinence; Urinary incontinence; Episiotomy; Natural childbirth; Extraction, obstetrical