Anal incontinence and Quality of Life in late pregnancy: a cross‐sectional study

Abstract

Objective To evaluate the association between different types of anal incontinence (AI) and Quality of Life (QoL) in late pregnancy.Design Cross-sectional study.Setting Two maternity units in Norway 2009-2010.Population Primiparae aged 18 or over.Methods Participants answered questions about AI during the last 4 weeks of pregnancy on the St. Mark's score and impact of QoL in the Fecal Incontinence QoL score. Socioeconomic data were obtained from hospital records.Main outcome measures Self-reported AI and impact on QoL.Results 1571 primiparae responded; 573 (37%) had experienced AI during the last 4 weeks of pregnancy. One third of the incontinent women reported reduced QoL in the domain 'Coping'. 'Women experiencing urgency alone reported markedly better QoL compared to any other AI symptoms. AI appeared to have the strongest impact on the domains 'Coping' and 'Embarrassment'. Depression was only associated with experiencing the combination of all three symptoms [odds ratio (OR) 13; 95%confidence interval (CI) 3.2-51]. Experiencing flatus alone weekly or more was associated with the highest impact on 'Embarrassment' (OR 20; 95%CI 6.4-61) compared with all other symptoms or combination of AI symptoms, except the combination of all three AI symptoms.Conclusions Between 3 and 10% of the primiparae in this material experienced AI to such a extent that it affected QoL. The greatest impact was seen in the QoL domain 'Coping'. These findings highlight the importance of an increased awareness of AI in late pregnancy among health professionals and the need to implement routine discussions about AI with expectant and new mothers.

Anal incontinence among first time mothers – What happens in pregnancy and the first year after delivery?

“…In the present study, the focus has thus been on AI rather than FI. Previous reports have shown that women report that frequent flatus incontinence causes embarrassment and affects the quality of life more than experiencing FI alone in late pregnancy, whereas urgency alone had little effect on quality of life unless experienced in combination with other AI symptoms . Thus, urgency was included in the definition of AI only when experienced in combination with other AI symptoms and participants were categorized into one of three groups: Continent or minor AI (no FI symptoms, flatus incontinence less than weekly or urgency alone). Moderate AI (one AI symptom; FI alone monthly or more, or flatus incontinence alone weekly or more). Severe AI (combinations of two or more AI symptoms: FI monthly or more, flatus incontinence weekly or more, or urgency/inability to defer defecation for 15 min). …”

Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3—exercise in the postpartum period

“…The prevalence of any type of urinary incontinence in primiparous women during the first year postpartum, regardless of delivery mode, is between 15% and 30% 110. Johannessen et al found that one in five primiparous women suffered from anal incontinence 1 year after delivery 111. The main predictor for anal incontinence 1 year postpartum was anal incontinence in late pregnancy.…”

Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1—exercise in women planning pregnancy and those who are pregnant

“…AI affects one in four primiparous women during the third trimester 303 304. In one study, the prevalence of AI, generally limited to flatus incontinence, was higher in women (aged 18–40 years) who exercised more than 8 h/week (14.8%) than in a comparison group (4.9%, p=0.001) 305.…”