Prevalence and Risk Indicators for Anal Incontinence among Pregnant Women

Katariina Laine,Leiv Sandvik,Finn Egil Skjeldestad,Anne Cathrine Staff

doi:10.1155/2013/947572

Abstract

The aim of this study was to assess the prevalence and risk factors of anal incontinence in an unselected pregnant population at second trimester. A survey of pregnant women attending a routine ultrasound examination was conducted in a university hospital in Oslo, Norway. A questionnaire consisting of 105 items concerning anal incontinence (including St. Mark's score), urinary incontinence, medication use, and comorbidity was posted to women when invited to the ultrasound examination. Results. Prevalence of self-reported anal incontinence (St. Mark's score ≥ 3) was the lowest in the group of women with a previous cesarean section only (6.4%) and the highest among women with a previous delivery complicated by obstetric anal sphincter injury (24.4%). Among nulliparous women the prevalence of anal incontinence was 7.7% and was associated to low educational level and comorbidity. Prevalence of anal incontinence increased with increasing parity. Urinary incontinence was associated with anal incontinence in all parity groups. Conclusions. Anal incontinence was most frequent among women with a history of obstetric anal sphincter injury. Other obstetrical events had a minor effect on prevalence of anal incontinence among parous women. Prevention of obstetrical sphincter injury is likely the most important factor for reducing bothersome anal incontinence among fertile women.

Highlights

Anal incontinence is a bothersome ailment associated with many health complaints and discomfort in daily life: hygienic problems, limitations in occupational and social life, sexual dysfunction, reduced quality of life, and altered self-esteem
Women who reported dermatological problems more frequently reported use of vitamins, allergy medication, and stomach and bowel regulators. These women reported more worries about the Cambridge worry scale than the women without dermatological problems. This population-based study showed that previous obstetric anal sphincter injury was the strongest risk factor for selfreported Anal incontinence (AI) among pregnant parous women
A low educational level and comorbidity were associated with anal incontinence

Summary

Introduction

Anal incontinence is a bothersome ailment associated with many health complaints and discomfort in daily life: hygienic problems, limitations in occupational and social life, sexual dysfunction, reduced quality of life, and altered self-esteem. Anal incontinence (AI) is defined as involuntary loss of flatus or feces [1]. Prevalence and severity of anal incontinence are measured by patient self-reporting and no objective assessment methods exist. Obstetric anal sphincter injury (OASIS) is one of the main causes for female AI reported in nonpregnant women. Multiple vaginal deliveries can increase the risk of AI regardless of anal sphincter injury [2, 3]. Obesity and medical conditions such as diabetic neuropathy and gastrointestinal disorders increase the risk of anal incontinence [2, 4, 5]

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