{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:08:17Z","timestamp":1791616097792,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T00:00:00Z","timestamp":1644192000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the relationship between anal incontinence (AI) 8\u00a0years after childbirth and the occurrence of obstetrical anal sphincter injuries (OASIS) and\/or performance of an episiotomy during childbirth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a nationwide database analysis performed on two national medico\u2010administrative databases, including all the women aged 18\u00a0years or older who delivered infants in France in 2012. The main outcome measure was AI in the 8\u00a0years after delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 163\u2009443 perineal tears reported, 0.47% were grade 3 (<jats:italic>n<\/jats:italic> = 3173) and 0.08% were grade 4 (<jats:italic>n<\/jats:italic> = 579); 8938 women experienced AI (1.33%) and 261 women experienced severe AI (0.04%). Episiotomies performed in the absence of risk factors for OASIS were significantly associated with an increased risk of AI (odds ratio [OR] 1.59, 95% confidence interval [CI]1.49\u20131.69; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Grade 3 and 4 OASIS also significantly increased the risk of AI and severe AI. Mediolateral episiotomy was preventive of OASIS when performed in women at risk (OR 0.26, 95% CI 0.23\u20130.30; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) but contributed to OASIS in the absence of risk (OR 2.18, 95% CI 1.98\u20132.40; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>OASIS present a risk factor for AI. Episiotomies could reduce the occurrence of OASIS, but they could also increase the risk of long\u2010term AI in the absence of risk factors for OASIS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14101","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T15:56:36Z","timestamp":1642607796000},"page":"284-289","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Obstetrical anal sphincter injury and unnecessary episiotomy are both associated with anal incontinence 8 years after childbirth: A nationwide database analysis"],"prefix":"10.1002","volume":"159","author":[{"given":"Mathieu","family":"Levaillant","sequence":"first","affiliation":[{"name":"Faculty of Health  Angers France"},{"name":"Universit\u00e9 de Lille, CHU Lille, ULR 2694\u2014METRICS: \u00c9valuation des technologies de sant\u00e9 et des pratiques m\u00e9dicales  Lille France"},{"name":"Department of Biostatistics CHU Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Legendre","sequence":"additional","affiliation":[{"name":"Faculty of Health  Angers France"},{"name":"Department of Gynecology and Obstetrics CHU Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Emeline","family":"Rebmann","sequence":"additional","affiliation":[{"name":"Faculty of Health  Angers France"},{"name":"Department of Visceral Surgery CHU Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Fran\u00e7ois","family":"Hamel","sequence":"additional","affiliation":[{"name":"Faculty of Health  Angers France"},{"name":"Universit\u00e9 de Lille, CHU Lille, ULR 2694\u2014METRICS: \u00c9valuation des technologies de sant\u00e9 et des pratiques m\u00e9dicales  Lille France"},{"name":"Ester Irset Inserm UMR 1085  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lien","family":"Venara","sequence":"additional","affiliation":[{"name":"Faculty of Health  Angers France"},{"name":"Department of Visceral Surgery CHU Angers  Angers France"},{"name":"IHFIH, UPRES EA 3859 University of Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0399-8320(06)73076-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0593-0"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000514"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.08.051"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14027"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gofs.2018.10.028"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2020.08.016"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gofs.2018.10.029"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16663"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1473-7"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.10.013"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01445.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04267-8"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)30081-0"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05878-8"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-021-04723-z"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v8.i16.3483"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.569"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16263"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3422-4"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2017.05.008"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05809-7"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-85717-1"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2016.06.025"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7227.86"}],"container-title":["International Journal of Gynecology &amp; 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