分娩后大便失禁的危险因素:525例患者前瞻性研究

来源 :世界核心医学期刊文摘(妇产科学分册) | 被引量 : 0次 | 上传用户:zeroorhero
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Objective. To determine the prevalence of fecal incontinence after childbirth and to identify the risk factors. Methods. 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. Results. 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 >93mm (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). Conclusion. 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. Methods. This was a prospective observational study with a subsequent inclusion of 525 women who delivered over a three-month period. Women were questioned about their fecal continence. Four days The incidence of fecal incontinence for 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% CI 1.30-50.0, p = 0.025). Independent risk factors for the presence of fecal incontinence 6 weeks later were: instrumental forceps (95% confidence interval 3.55-21.0, pO.001) and unassisted delivery at home 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). Conclusion 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.
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