Prevalence and Associated Factors of Anal Incontinence at Six Weeks after Vaginal Delivery: A Cross-sectional Study at Three Teaching Hospitals in Addis Ababa, Ethiopia

埃塞俄比亚亚的斯亚贝巴三家教学医院阴道分娩后六周肛门失禁的患病率及相关因素:一项横断面研究

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Abstract

BACKGROUND: Anal incontinence is defined as the involuntary loss of fecal material or flatus. The reported prevalence at 6 weeks postpartum varies from 4% to 39%. It is associated with reduced quality of life, negative psychogenic effects and social stigma. This study was done to assess its prevalence at 6 weeks after vaginal delivery and identify the associated factors. METHODS: This is a cross-sectional descriptive study. Data was collected using questionnaire adapted from International Consultation on Incontinence Questionnaire on Urinary Incontinence-Short Form. Data was analyzed using SPSS version 20.5. RESULT: The prevalence of anal incontinence at 6 weeks after vaginal delivery was 8.6%. The majority of the cases, 28 (84.8%), had only flatus incontinence. Participants of age group 20-35 years had significantly lower odds of having anal incontinence compared to those above age 35 (P < 0.05). The odds of having incontinence compared to spontaneous vaginal delivery was about 5 times higher for forceps (AOR= 4.93 (95%CI:1.48, 16.44)) and vacuum (AOR= 5.53 (95%CI:1.18, 25.96)) deliveries. Second stage of labor duration of >120 minutes had more than 4 times odds of developing incontinence compared to duration of <30 minutes (AOR= 4.79 (95%CI:1.01, 22.82)). Second degree perineal tear was the most significantly associated variable compared to those without tear (AOR= 12.31 (95%CI:3.89, 39.00)). CONCLUSION: The prevalence of anal incontinence at 6 weeks after vaginal delivery was 8.6%. Maternal age, mode of delivery, duration of second stage of labor and perineal tear were the significantly associated factors.

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