Specific obstetrical risk factors for urinary versus anal incontinence 4years after first delivery.Reportar como inadecuado




Specific obstetrical risk factors for urinary versus anal incontinence 4years after first delivery. - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

* Corresponding author 1 Poitiers University Hospital CIC - Poitiers 2 U953 Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants 3 UVSQ RISCQ - Risques cliniques et sécurité en santé des femmes et en santé périnatale

Abstract : AIM: Delivery can be complicated by urinary or anal incontinence UI or AI. We hypothesized that the mechanisms of injury may differ for UI and AI. Hence, obstetrical risk factors may be specific for different types of incontinence. DESIGN: Data on maternal characteristics were collected at first delivery. Data on incontinence were obtained by a questionnaire completed by 627 women 4years after first delivery. UI was defined by -Do you have involuntary loss of urine- and AI by -Do you have involuntary loss of flatus or stool-. A multinomial logistic regression analysis was conducted to assess risk factors for UI only, AI only, and UI+AI. RESULTS: Twenty-two percent of women reported UI only, 6.5% AI only, and 6.5% both. Risk factors associated with UI only were age at first delivery≥30 OR 2.27 95% CI 1.47-3.49, pre-existing UI 6.44 2.19-19.0 and pregnancy UI 3.64 2.25-5.91. Risk factors associated with AI only were length of the second active stage>20minutes 2.86 1.15-7.13 and third degree perineal tear 20.9 1.73-252. Significant predictors of UI+AI were age≥30 2.65 1.29-5.46, no epidural 4.29 1.65-11.1, third degree perineal tear 20.0 1.28-314, and UI before pregnancy 32.9 9.00-120. Cesarean delivery was not significantly associated with UI, AI, or UI+AI, although for all three outcomes, the adjusted odds ratios were substantially less than one. CONCLUSION: We found specific associations between obstetrical risk factors and urinary versus anal incontinence 4years after first delivery. Our results are consistent with the hypothesis that the underlying mechanisms of injury differ for UI and AI.

keyword : urinary incontinence anal incontinence delivery





Autor: Xavier Fritel - Babak Khoshnood - Arnaud Fauconnier -

Fuente: https://hal.archives-ouvertes.fr/



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