RESUMO
Objetivos: Determinar la prevalencia de la incontinencia anal (IA) para heces y gases y los factores asociados propios del parto y de la madre. Diseño: Estudio observacional prospectivo longitudinal con seguimiento a los 2, 6 y 12 meses del parto. Ámbito de estudio: El Hospital General de Vic como hospital general básico de la comarca de Osona (Cataluña central).Sujetos de estudio: Mujeres con un parto a término de recién nacido vivo entre el 1 de Enero de 2001 y el 31 de Marzo de 2002.MetodologíaDurante el ingreso por parto se recogieron datos de 707 madres (edad, paridad, índice masa corporal, síntomas de incontinencia durante el embarazo), del tipo de parto (vaginal, cesárea) y del feto (peso, circunferencia craneal). A los dos meses del parto, fueron visitadas por un ginecólogo para detectar y establecer el diagnóstico clínico de incontinencia anal mediante un protocolo específico. Las mujeres con síntomas de incontinencia anal a los dos meses del parto, eran visitadas a los seis meses y a los 12 meses entrevistadas por teléfono. Se calculó la prevalencia de IA a los dos, seis y doce meses del parto y la asociación de los síntomas de IA con factores maternos, fetales y del parto. Resultados: De las 531 mujeres visitadas a los dos meses del parto, 11 fueron diagnosticadas de incontinencia anal. A los 12 meses, 4 (36,4%) seguían con síntomas de incontinencia. La prevalencia de incontinencia anal a los dos meses del parto fue del 2,1% (IC 0,95: 1,0-3,7) y se asoció a la primiparidad (odds ratio [OR]=7,21; p=0,029) y al parto instrumental con fórceps (OR=5,54, p=0,021). Conclusiones: La prevalencia de síntomas de incontinencia anal a los dos meses postparto es baja; en la mitad de las mujeres los síntomas de IA persisten a los 6 y los 12 meses del parto. La primiparidad y el parto instrumental con fórceps, se asociaron a los síntomas de IA a los dos meses del parto (AU)
Objectives: To determine the prevalence of anal incontinence (AI) of faeces and gases, as well as the factors associated with the pregnancy, delivery and postpartum.DesignTwelve-month follow-up study with visits at 2, 6 and 12 months. Settings: Vic General Hospital as a basic general hospital in the Osona region (Central Catalonia, Spain).Subject of the study Women who had a live birth at full-term between the 1st of January 2001 and the 31st of March 2002. Methodology: During admission for childbirth, data were collected on the mother (age, parity, body mass index, symptoms of incontinence during pregnancy), the type of delivery (vaginal, caesarean) and the foetus (weight, cranial circumference). Two months after parturition, the mothers were examined by a gynaecologist to detect and establish the clinical diagnosis of anal incontinence by means of a specific protocol. The women were asked whether they had symptoms of involuntary release of faeces or gases: women with symptoms of AI underwent a pelvic examination before being referred to a specialist in coloproctology for an assessment. Women with symptoms of AI at 2 months postpartum were recalled at 6 months for a new clinical assessment by the gynaecologist, and after 12 months all those who had shown persistence of symptoms at 6 months were contacted by phone. The prevalence of anal incontinence at 2 months postpartum was calculated and also the association of symptoms with maternal, foetal and delivery factors. Results: A total of 531 women were visited at 2 months postpartum. Of these, 11 were diagnosed with anal incontinence. At 12 months post partum, 4 (36.4%) of these 11 women continued to have symptoms of incontinence. The prevalence of anal incontinence at 2 months after delivery was 2.1% (95% CI: 1.0-3.7) and was associated with primiparity (Odds ratio [OR]=7.21, P=0.029) and forceps use (OR=5.54, P=0.021) (AU)
