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Prevalence of Fecal Incontinence in Women During Pregnancy: A Large Cross-Sectional Study

Parés, David M.D., Ph.D.1; Martinez-Franco, Eva M.D., Ph.D.2; Lorente, Nuria M.D.2; Viguer, Jordi M.D.2; Lopez-Negre, Jose-Luis M.D., Ph.D.1; Mendez, Josep-Ramon M.D.2

doi: 10.1097/DCR.0000000000000471
Original Contributions: Pelvic Floor

BACKGROUND: Although some studies have analyzed the prevalence of urinary incontinence during pregnancy, there are scarce data on the frequency and characteristics of fecal incontinence during this period.

OBJECTIVE: The aim of this study was to determine the incidence and characteristics of women with fecal incontinence symptoms during early and late pregnancy, to evaluate its impact on quality of life, and to identify whether there is a specific clinical pattern that could identify patients at risk.

DESIGN: This was a cross-sectional observational study.

SETTINGS: The study was conducted at the maternity unit of a university tertiary care center.

PATIENTS: Pregnant women undergoing obstetric follow-up were included in the study.

MAIN OUTCOME MEASURES: A prospective study was conducted. All of the patients attending our maternity unit for obstetric ultrasound examination during the first and third trimesters were eligible for inclusion. Selected patients completed a self-reported questionnaire that included items on fecal incontinence, Wexner score, and stool consistency. Quality of life was assessed using the Medical Outcomes Study Short Form 36.

RESULTS: The study included 228 consecutive pregnant women. Ninety-three patients (40.8%) had some episode of fecal incontinence in the 4 weeks before the survey, 15 patients with solid stool, 6 patients with liquid stools, and 72 with flatus. In these patients, the mean Wexner score was 3.82 (range, 2.0–13.0). In patients with incontinence, quality of life was significantly affected in most subscales of Medical Outcomes Study Short Form 36. There were no significant differences in the following variables between patients with and without symptoms of fecal incontinence, including age (p = 0.090), BMI (p = 0.094), history of previous deliveries (p = 0.492), trimester of pregnancy (p = 0.361), and Bristol Stool Form Scale (p = 0.388).

LIMITATIONS: The cross-sectional design hampered identification of specific time at which the impact of pregnancy occurred.

CONCLUSIONS: The prevalence of fecal incontinence is high during pregnancy with a notable impact on quality of life. There was no specific clinical pattern during pregnancy that could define patients at risk for fecal incontinence during this period of life.

1 Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain

2 Department of Obstetrics and Gynaecology, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain

Financial Disclosure: None reported.

Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Hollywood, FL, May 17 to 21, 2014.

Correspondence and present address: David Parés, M.D., Ph.D., Department of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth NHS Trust, Southwick Hill Road, Cosham, Portsmouth PO6 3OLY, United Kingdom. E-mail: dapares@gmail.com

© 2015 The American Society of Colon and Rectal Surgeons