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

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.