Anal incontinence and Quality of Life in late pregnancy: a cross-sectional study
Article first published online: 4 MAR 2014
© 2014 Royal College of Obstetricians and Gynaecologists
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 121, Issue 8, pages 978–987, July 2014
How to Cite
Anal incontinence and Quality of Life in late pregnancy: a cross-sectional study. BJOG 2014;121:978–987., , , , .
- Issue published online: 24 JUN 2014
- Article first published online: 4 MAR 2014
- Manuscript Accepted: 18 NOV 2013
- Norwegian Women's Public Health Association/the Norwegian Extra Foundation
- Ostfold Hospital Trust
- St. Olavs Hospital Trondheim University Hospital
- Norwegian University of Science and Technology and the Liaison Committee
- Central Norway Regional Health Authority (RHA)
- Norwegian University of Science and Technology (NTNU)
- Anal incontinence;
- Quality of Life
To evaluate the association between different types of anal incontinence (AI) and Quality of Life (QoL) in late pregnancy.
Two maternity units in Norway 2009–2010.
Primiparae aged 18 or over.
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.
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.
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.