Fritel Xavier, Ringa Virginie, Varnoux Noëlle, Zins Marie, Bréart Gérard
Institut national de la santé et de la recherche médicale (INSERM), UMR S149, IFR69, Epidemiological Research on Perinatal Health and Women's Health, Villejuif, France.
Obstet Gynecol. 2007 Jul;110(1):31-8. doi: 10.1097/01.AOG.0000266981.69332.db.
To estimate obstetric risk factors of fecal incontinence among middle-aged women.
We conducted a mail survey of the Gazel cohort of volunteers for epidemiologic research. In 2000, a questionnaire on anal incontinence was mailed to 3,114 women who were then between the ages of 50 and 61 years; 2,640 (85%) women returned the completed questionnaire. Fecal incontinence was defined by involuntary loss of stool. Logistic regression was used to estimate the effect of obstetric and general risk factors.
Prevalence of fecal incontinence in the past 12 months was 9.5% (250). Significant risk factors for fecal incontinence were completion of high school (adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.0), self-reported depression (OR 2.1, 95% CI 1.6-2.7), overweight or obesity measured by body mass index (BMI) (OR 1.5 for BMI of 25-30, 95% CI 1.1-2.0; OR 1.6 for BMI more than 30, 95% CI 1.1-2.5), surgery for urinary incontinence (OR 3.5, 95% CI 2.0-6.1), and anal surgery (OR 1.7, 95% CI 1.1-2.9). No obstetric variable (parity, mode of delivery, birth weight, episiotomy, or third-degree perineal tear) was significant. Prevalence of fecal incontinence was similar for nulliparous, primiparous, secundiparous, and multiparous women (11.3%, 9.0%, 9.0%, and 10.4%, respectively), and among parous women, it was similar for women with spontaneous vaginal, instrumental (at least one), or only cesarean deliveries (9.3%, 10.0%, and 6.6%, respectively).
In our population of women in their 50s, fecal incontinence was not associated with either parity or mode of delivery.
评估中年女性大便失禁的产科危险因素。
我们对Gazel队列的志愿者进行了邮件调查，以开展流行病学研究。2000年，一份关于肛门失禁的问卷被邮寄给3114名年龄在50至61岁之间的女性；2640名（85%）女性返回了填写完整的问卷。大便失禁定义为不自主排便。采用逻辑回归来评估产科和一般危险因素的影响。
过去12个月中大便失禁的患病率为9.5%（250例）。大便失禁的显著危险因素包括高中毕业（调整后的优势比[OR]为1.5，95%置信区间[CI]为1.1 - 2.0）、自我报告的抑郁（OR为2.1，95% CI为1.6 - 2.7）、通过体重指数（BMI）衡量的超重或肥胖（BMI为25 - 30时OR为1.5，95% CI为1.1 - 2.0；BMI大于30时OR为1.6，95% CI为1.1 - 2.5）、尿失禁手术（OR为3.5，95% CI为2.0 - 6.1）以及肛门手术（OR为1.7，95% CI为1.1 - 2.9）。没有产科变量（产次、分娩方式、出生体重、会阴切开术或三度会阴撕裂）具有显著性。未生育、初产、经产和多产女性的大便失禁患病率相似（分别为11.3%、9.0%、9.0%和10.4%），在经产女性中，自然阴道分娩、器械助产（至少一次）或仅剖宫产的女性患病率相似（分别为9.3%、10.0%和6.6%）。
在我们研究的50多岁女性人群中，大便失禁与产次或分娩方式均无关。
