Roman H, Robillard P-Y, Payet E, El Amrani R, Verspyck E, Marpeau L, Barau G
Service de Gynécologie et Obstétrique, Groupe Hospitalier Sud Réunion, 97448 Saint-Pierre, Ile de la Réunion, France.
J Gynecol Obstet Biol Reprod (Paris). 2004 Oct;33(6 Pt 1):497-505. doi: 10.1016/s0368-2315(04)96562-3.
To determine the prevalence of fecal incontinence after childbirth and to identify the risk factors.
This was a prospective observational study with a consecutive inclusion of 525 women who delivered over a three months period. Women were questioned about their fecal continence four days and six weeks after delivery.
The incidence of fecal incontinence four days and six weeks after childbirth was respectively 8.8% and 3.3%. The risk factors for fecal incontinence at 4 days after childbirth were instrumental delivery by forceps (adjusted odds ratio 8.64, 95% confidence interval 3.55-21.0, p < 0.001) and unassisted delivery at home (adjusted OR 8.06, 95% CI 1.30-50.0, p = 0.025). Independent risk factors for the presence of fecal incontinence 6 weeks later were: instrumental forceps delivery (adjusted OR 10.8, 95% CI 2.82-41.3, p = 0.001), unassisted delivery at home (adjusted OR 50.0, 95% CI 3.09-802, p = 0.006), bi-parietal diameter of the newborn > 93 mm (adjusted OR 4.56, 95% CI 1.46-14.1, p = 0.009) and maternal age >30 years (adjusted OR 4.60, 95% CI 1.11-19.1, p = 0.036).
Fecal incontinence is common after childbirth and its prevalence is predominantly associated with instrumental delivery, unassisted delivery at home, bi-parietal diameter of the newborn and maternal age.
确定产后大便失禁的患病率并识别风险因素。
这是一项前瞻性观察性研究，连续纳入了在三个月期间分娩的525名妇女。在分娩后四天和六周对妇女进行了关于大便失禁情况的询问。
产后四天和六周时大便失禁的发生率分别为8.8%和3.3%。产后4天大便失禁的风险因素是产钳助产（调整后的优势比为8.64，95%置信区间为3.55 - 21.0，p < 0.001）和在家自然分娩（调整后的优势比为8.06，95%置信区间为1.30 - 50.0，p = 0.025）。六周后存在大便失禁的独立风险因素为：产钳助产（调整后的优势比为10.8，95%置信区间为2.82 - 41.3，p = 0.001）、在家自然分娩（调整后的优势比为50.0，95%置信区间为3.09 - 802，p = 0.006）、新生儿双顶径>93 mm（调整后的优势比为4.56，95%置信区间为1.46 - 14.1，p = 0.009）以及产妇年龄>30岁（调整后的优势比为4.60，95%置信区间为1.11 - 19.1，p = 0.036）。
产后大便失禁很常见，其患病率主要与助产、在家自然分娩、新生儿双顶径和产妇年龄有关。
