{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:45:31Z","timestamp":1791877531346,"version":"4.3.4"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006636","name":"Forskningsr\u00e5det f\u00f6r h\u00e4lsa, arbetsliv och v\u00e4lf\u00e4rd","doi-asserted-by":"publisher","award":["2025\u201000660"],"award-info":[{"award-number":["2025\u201000660"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and validate a prediction model estimating the individual risk of anal incontinence 1 year postpartum following second\u2010, third\u2010 and fourth\u2010degree perineal tears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Development of a prognostic prediction model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data were retrieved from three Swedish health and quality registers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>8909 primiparous women with second\u2010, third\u2010 and fourth\u2010degree perineal tears who delivered vaginally at \u2265\u200934\u2009weeks' gestation between 2014 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventeen predictors were identified as candidate variables. A prediction model was built using logistic regression to predict anal incontinence at 1 year postpartum. Additional models were built for gas and faecal incontinence. Model performance was assessed using the Efron\u2010Gong optimism bootstrap. Temporal validation was conducted in a separate cohort of women who delivered between 2020 and 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure<\/jats:title>\n                    <jats:p>Anal incontinence (gas and\/or faecal incontinence) at 1 year postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven variables remained in the final model for anal incontinence. A high Wexner score was the strongest predictor of anal incontinence at 1 year postpartum. The models accurately predicted anal incontinence (AUC 0.78, 95% CI: 0.76\u20130.80), faecal incontinence (AUC 0.80, 95% CI: 0.77\u20130.83), and gas incontinence (AUC 0.78, 95% CI: 0.76\u20130.80). Calibration curves demonstrated that all models were accurate, particularly for women with third\u2010degree tears. Temporal validation confirmed the high accuracy (AUC 0.78; 95% CI: 0.75\u20130.81).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The article presents an accurate prediction model for anal incontinence at 1 year after vaginal delivery among women with second\u2010, third\u2010 and fourth\u2010degree perineal tears, based on perineal laceration register data collected at 8\u2009weeks postpartum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70342","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:51:28Z","timestamp":1791874288000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anal Incontinence in Primiparous Women With Second\u2010 to Fourth\u2010Degree Perineal Tears One Year After Vaginal Delivery: Development and Validation of a Multivariable Prediction Model"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6577-3963","authenticated-orcid":false,"given":"Mette L.","family":"Josefsson","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3268-8810","authenticated-orcid":false,"given":"Erik","family":"Lampa","sequence":"additional","affiliation":[{"name":"Epistat  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3299-8437","authenticated-orcid":false,"given":"Eva","family":"Uustal","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Sohlberg","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6396-3930","authenticated-orcid":false,"given":"Cecilia","family":"Ek\u00e9us","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2657-1958","authenticated-orcid":false,"given":"Maria","family":"Jonsson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010009\u20100976\u20109"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.3276"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0b013e3282ef4142"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.308.6933.887"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100412.2010.01057.x"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14027"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b375"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.06.013"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2023.104546"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010014\u20100241\u2010z"},{"key":"e_1_2_14_12_1","unstructured":"\u201cSwedish National Quality Register of Gynecological Surgery \u201d (2018) https:\/\/www.gynop.se\/home\/."},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.70124"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010023\u201005609\u2010y"},{"issue":"7","key":"e_1_2_14_15_1","first-page":"603","article-title":"Reliability of the Hospital Registry. 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