Postpartum psychological distress associated with anal incontinence in the EDEN mother–child cohort

Authors:
  • TGthe EDEN Mother–Child Cohort Study Group
    the EDEN Mother–Child Cohort Study Group
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Abstract
Objective: To estimate the prevalence of flatus‐only and faecal incontinence, to describe their risk factors and to analyse the association between anal incontinence and psychological distress over the first year postpartum.Design: Cohort study from pregnancy to 12 months postpartum.Setting: Two university hospital maternity wards in France.Population: A total of 2002 pregnant women were recruited between 2003 and 2006. Data on anal incontinence were available for the 1632 women who comprise the sample for analysis.Methods: Women were enrolled during pregnancy. A postal questionnaire was sent at 4 and 12 months postpartum.Main outcome measures: Anal (flatus‐only and faecal) incontinence was assessed at 4 months postpartum. Mental health was assessed at 4 and 12 months postpartum by the Edinburgh Postpartum Depression Scale (EPDS) and use of antidepressant drugs as well as by self‐rated mental health.Results: At 4 months postpartum, the prevalence for flatus‐only incontinence was 14.4% and for faecal incontinence 1.7%; multivariate analysis, restricted to women reporting no anal incontinence before the index pregnancy, showed that continuing breastfeeding at 4 months was related to a higher risk of de novo postpartum anal incontinence (OR = 2.23). Women who reported anal incontinence at 4 months were more frequently depressed (EPDS ≥10 or antidepressant use) at 12 months postpartum: 36.0% of those with faecal incontinence were depressed, 23.3% of those with flatus‐only incontinence and only 14.8% of the continent women.Conclusion: Postnatal faecal incontinence was rare but associated with poorer maternal mental health. Postnatal screening should be encouraged, and psychological support offered.Tweetable Postnatal faecal incontinence was associated with depression; postnatal screening should be encouraged and psychological support offered.
Funding Information
  • Fondation pour la Recherche Médicale
  • Institut National de la Santé et de la Recherche Médicale
  • Agence Nationale de la Recherche
  • Ministère de la Santé

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