{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T04:07:40Z","timestamp":1790482060731,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,1,19]],"date-time":"2020-01-19T00:00:00Z","timestamp":1579392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002915","name":"Fondation pour la Recherche M\u00e9dicale","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002915","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001677","name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001677","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004690","name":"Minist\u00e8re de la Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004690","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate the prevalence of flatus\u2010only and faecal incontinence, to describe their risk factors and to analyse the association between anal incontinence and psychological distress over the first year postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cohort study from pregnancy to 12\u00a0months postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two university hospital maternity wards in France.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women were enrolled during pregnancy. A postal questionnaire was sent at 4 and 12\u00a0months postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Anal (flatus\u2010only and faecal) incontinence was assessed at 4\u00a0months postpartum. Mental health was assessed at 4 and 12\u00a0months postpartum by the Edinburgh Postpartum Depression Scale (EPDS) and use of antidepressant drugs as well as by self\u2010rated mental health.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 4\u00a0months postpartum, the prevalence for flatus\u2010only 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\u00a0months was related to a higher risk of de novo postpartum anal incontinence (OR\u00a0=\u00a02.23). Women who reported anal incontinence at 4\u00a0months were more frequently depressed (EPDS \u226510 or antidepressant use) at 12\u00a0months postpartum: 36.0% of those with faecal incontinence were depressed, 23.3% of those with flatus\u2010only incontinence and only 14.8% of the continent women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Postnatal faecal incontinence was rare but associated with poorer maternal mental health. Postnatal screening should be encouraged, and psychological support offered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Postnatal faecal incontinence was associated with depression; postnatal screening should be encouraged and psychological support offered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16075","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T07:42:20Z","timestamp":1577173340000},"page":"619-627","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Postpartum psychological distress associated with anal incontinence in the EDEN mother\u2013child cohort"],"prefix":"10.1111","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4987-8127","authenticated-orcid":false,"given":"X","family":"Fritel","sequence":"first","affiliation":[{"name":"Gynaecology and Obstetrics Department University Hospital of Poitiers Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Gachon","sequence":"additional","affiliation":[{"name":"Gynaecology and Obstetrics Department University Hospital of Poitiers Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MJ","family":"Saurel\u2010Cubizolles","sequence":"additional","affiliation":[{"name":"Epidemiology and Statistics Research Centre\/CRESS\u2010EPOP\u00e9 INSERM INRA Universit\u00e9 de Paris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EDEN Mother\u2013Child Cohort Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp011542"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.11.033"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2013.10.003"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.10.056"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/30.6.503"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14521"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000266981.69332.db"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1997.tb10648.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)32402-1"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00183.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365529950173753"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-005-1351-0"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.115997"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00185.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gofs.2018.01.004"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.02073.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr.07.2009.2118"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11607.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.604"},{"key":"e_1_2_6_21_1","first-page":"53","article-title":"Postcesarean pelvic floor dysfunction contributes to undisclosed psychosocial morbidity","volume":"54","author":"Lal M","year":"2009","journal-title":"J Reprod Med"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00721.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv151"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02049407"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22552"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.150.6.782"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/003591576505800503"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2015.12.028"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12963"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13037"},{"key":"e_1_2_6_31_1","volume-title":"The management of third\u2010 and fourth\u2010degree perineal tears","author":"Royal college of Gynaecologists and Obstetricians"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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