Kozeluhova J, Kotyza J, Balihar K, Krcma M, Cedikova M, Karbanova J, Kalis V, Janska E, Matejovic M
Bratisl Lek Listy. 2017;118(6):328-333. doi: 10.4149/BLL_2017_072a.
The aim of our prospective study was to evaluate the development of postpartum anal incontinence in patients with inflammatory bowel disease (IBD) compared to healthy women.
Patients with IBD and healthy controls enrolled in the study from January 1st 2013 to November 30th 2016 and filled in the anal incontinence questionnaire in the beginning of pregnancy and after vaginal delivery. The results were statistically processed using suitable tests.
A total of 57 women were enrolled, 17 (29.8 %) with ulcerative colitis, 23 (40.4 %) with Crohn's disease, and 17 (29.8 %) healthy controls. Incidence of postpartum anal incontinence is comparable across all groups; there was no statistically significant difference between the IBD and control groups (Kruskal-Wallis test by ranks with Dunn correction, non-significant). Postpartum anal incontinence was strongly correlated with the extent of perineal injury (r = 0.80; p < 0.0001; Pearson's linear correlation).
Women with inflammatory bowel disease in remission do not exhibit higher incidence of postpartum anal incontinence (PPAI) compared to healthy controls; the key correlate of PPAI appears to be the extent of obstetric injury, consistently across all study groups. These results suggest that concerns about postpartum anal incontinence development should not be an indication for Caesarean section in IBD patients (Tab. 6, Fig. 1, Ref. 34).
我们这项前瞻性研究的目的是评估炎症性肠病（IBD）患者与健康女性相比产后肛门失禁的发生情况。
2013年1月1日至2016年11月30日期间，IBD患者和健康对照者纳入本研究，并在妊娠初期和阴道分娩后填写肛门失禁问卷。使用合适的检验对结果进行统计学处理。
共纳入57名女性，其中17名（29.8%）患有溃疡性结肠炎，23名（40.4%）患有克罗恩病，17名（29.8%）为健康对照者。所有组产后肛门失禁的发生率相当；IBD组和对照组之间无统计学显著差异（经Dunn校正的Kruskal-Wallis秩和检验，无显著性）。产后肛门失禁与会阴损伤程度密切相关（r = 0.80；p < 0.0001；Pearson线性相关）。
与健康对照者相比，处于缓解期的炎症性肠病女性产后肛门失禁（PPAI）的发生率并未更高；在所有研究组中，PPAI的关键相关因素似乎是产科损伤的程度。这些结果表明，对于IBD患者，不应将对产后肛门失禁发生的担忧作为剖宫产的指征（表6，图1，参考文献34）。
