Evidence map›Paper›PMID 37338103›Full record

ArticleActa obstetricia et gynecologica Scandinavica2023

Fecal incontinence and associated pelvic floor dysfunction during and one year after the first pregnancy.

Markus Harry Jansson, Karin Franzén, Gunilla Tegerstedt, Jan Brynhildsen, Ayako Hiyoshi, Kerstin Nilsson

Open access · diamondAbstract read
In one paragraph

Article in Acta obstetricia et gynecologica Scandinavica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
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  3. Review
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  5. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Markus Harry JanssonDepartment of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID 0000-0002-1776-1338
Karin FranzénSchool of Medical Sciences, Faculty of Health and Medicine, Örebro University, Örebro, Sweden.
Gunilla TegerstedtUnit of Obstetrics and Gynecology, CLINTEC, Karolinska University Hospital at Huddinge, Karolinska Institute, Stockholm, Sweden.
Jan BrynhildsenDepartment of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Ayako HiyoshiClinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Kerstin NilssonSchool of Medical Sciences, Faculty of Health and Medicine, Örebro University, Örebro, Sweden.
Örebro University · SEKarolinska University Hospital · SE

Funding

Region Örebro län OLL-930507Region Örebro län OLL-939402Region Stockholm ALF FundingSvenska Läkaresällskapet SLS-250351Universitetssjukhuset Örebro OLL-410421
6 · The paper itself

Abstract

introductionObstetric anal sphincter injury is an important risk factor for postpartum fecal incontinence but few studies have reported fecal incontinence occurring, even during pregnancy. The first objective of this study was to examine the prevalence of fecal incontinence, obstructed defecation and vaginal bulging early and late in pregnancy and postpartum. The second objective was to assess the association between symptoms in pregnancy, delivery characteristics, and bowel and vaginal bulging symptoms at 1 year postpartum. MATERIAL AND

methodsThis prospective cohort study was conducted between October 2014 and October 2017, including 898 nulliparous women enrolled with the maternity healthcare service in Örebro County, Sweden. The women responded to questionnaires regarding pelvic floor dysfunction in early and late pregnancy and at 8 weeks and 1 year postpartum. The data were analyzed using random effect logistic models estimating odds ratios (ORs) and generalized linear models estimating relative risks, with 95% confidence intervals (CIs).

resultsAt 1 year postpartum, the prevalence of fecal incontinence, obstructed defecation and vaginal bulging was 6% (40/694), 28% (197/699) and 8% (56/695), respectively. Among women with vaginal delivery, the risk of fecal incontinence and vaginal bulging increased significantly both in late pregnancy, with ORs of 3.4 (95% CI 1.5-7.7) and 3.6 (95% CI 1.6-8.1), respectively, and at 1 year postpartum, with ORs of 5.0 (95% CI 2.1-11.5) and 8.3 (95% CI 3.8-18.1), respectively, compared with early pregnancy. Among all women, factors associated with increased prevalence of fecal incontinence 1 year postpartum were fecal incontinence during pregnancy (adjusted relative risk [aRR] 7.4; 95% CI 4.1-13.3), obstructed defecation during pregnancy (aRR 2.0; 95% CI 1.1-3.9) and concurrent obstructed defecation (aRR 2.4; 95% CI 1.3-4.5).

conclusionsThis prospective study shows an increased risk of fecal incontinence by late pregnancy, suggesting that the pregnancy itself may be involved in the development of postpartum fecal incontinence. Obstructed defecation during pregnancy and postpartum was found to be associated with increased risk of fecal incontinence postpartum, indicating that postpartum fecal incontinence may be a result of incomplete bowel emptying.

Indexed as

Fecal IncontinenceDelivery, ObstetricFemaleGravidityHumansPelvic FloorPregnancyProspective StudiesSurveys and Questionnairesanal incontinencefecal incontinenceincomplete bowel evacuationobstructed defecationpelvic organ prolapseprospective cohort studyvaginal bulging

Identifiers

PMID37338103
PMCPMC10378031
OpenAlexW4381308613

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.