Prevalence of anal incontinence among mothers of multiples and analysis of risk factors

Objective The object of this study was to determine the prevalence of anal incontinence among women with previous multiple pregnancy and childbirth and assess risk factors. Study design A 77-item questionnaire was administered to 769 mothers of multiples. Statistical analyses included χ2, Student t test, and logistic regression. Results Seven hundred thirty-three (95.3%) women completed the survey, 94% of them white, with a median age of 37 years. Fecal incontinence affected 10% (6.3% arose during pregnancy, 40.6% after delivery, 53.1% unrelated to childbirth). Although delivery by cesarean section only was associated with lower prevalence in univariate analysis (5.8% vs 11%, P = .02), age was the only significant covariate in multivariate regression (P = .0001). Flatal incontinence affected 25.2% (21.2% during pregnancy, 30.3% after delivery, 48.5% unrelated), increasing with age (P = .0001). Soiling affected 10%, increasing with age (P = .0001). Conclusion Mothers of multiples reported substantial rates of fecal (10%) and flatal (25.2%) incontinence. Advancing age was the major risk factor. Delivery by cesarean section only was not significantly protective, although elective (before labor) cesarean deliveries were not separately assessed.