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

Authors

  • HH Johannessen,

    Corresponding author
    1. Department of Physiotherapy, Østfold Hospital Trust, Fredrikstad, Norway
    2. Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
    • Correspondence: Hege Hølmo Johannessen, Department of Quality and Research, P.O. Box 16, Ostfold Hospital Trust, 1603 Fredrikstad, Norway. Email: hege.holmo.johannessen@so-hf.no

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  • S Mørkved,

    1. Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
    2. Department of Research, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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  • A Stordahl,

    1. Department of Surgery, Østfold Hospital Trust, Fredrikstad, Norway
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  • L Sandvik,

    1. Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
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  • A Wibe

    1. Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
    2. Department of Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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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.

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