{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:55:22Z","timestamp":1786964122813,"version":"build-2736575974"},"reference-count":54,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2010,12,31]],"date-time":"2010-12-31T00:00:00Z","timestamp":1293753600000},"content-version":"vor","delay-in-days":305,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Background.<\/jats:italic> Conflicting results are reported about the contribution of maternal, obstetric and fetal characteristics to postpartum fecal incontinence (FI), which is hampering prevention and management of FI. <jats:italic>Objective<\/jats:italic>. To perform a systematic review identifying delivery\u2010related etiological factors for postpartum FI. <jats:italic>Search strategy.<\/jats:italic> Literature searches of PubMed, EMBASE, CINAHL, DocOnline and reference lists from 1980 up to 2009 were conducted. <jats:italic>Selection criteria.<\/jats:italic> Prospective cohort studies evaluating maternal, obstetric or fetal risk factors for postpartum FI, with a follow\u2010up period of at least three months, were assessed. We reviewed full reports in English, German or Dutch, with anal incontinence (AI), FI, flatus incontinence, soiling, urgency and FI severity scores as reported outcomes. <jats:italic>Data collection and analysis.<\/jats:italic> Data on study characteristics, methodological quality and outcome were extracted from 31 studies according to a standardized protocol. Clinical and methodological sources of heterogeneity permitted only a qualitative analysis. <jats:italic>Main results.<\/jats:italic> A third\u2010 or fourth\u2010degree sphincter rupture was the only etiological factor strongly (AI) or moderately (flatus incontinence) associated with postpartum FI. No association with other postulated risk factors was found, for example, birth weight or instrumental delivery. The potential co\u2010existence of different risk factors impedes the interpretation of the influence of a single delivery\u2010related risk factor. <jats:italic>Conclusions.<\/jats:italic> This systematic review, including only longitudinal studies and recognizing the importance of separating results for different outcomes, identifies that a third\u2010 or fourth\u2010degree sphincter rupture is the only factor that is strongly (AI) or moderately (flatus incontinence) associated with postpartum FI.<\/jats:p>","DOI":"10.3109\/00016340903576004","type":"journal-article","created":{"date-parts":[[2010,3,4]],"date-time":"2010-03-04T12:38:23Z","timestamp":1267706303000},"page":"302-314","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":106,"title":["A systematic review of etiological factors for postpartum fecal incontinence"],"prefix":"10.1111","volume":"89","author":[{"given":"ESTHER M.J.","family":"BOLS","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ERIK J.M.","family":"HENDRIKS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BARY C.M.","family":"BERGHMANS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"COR G.M.I.","family":"BAETEN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JAN G.","family":"NIJHUIS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ROB A.","family":"DE BIE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,12,31]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0593-0"},{"key":"e_1_2_7_3_2","article-title":"Faecal incontinence: the management of faecal incontinence in adults","volume":"49","author":"National Collaborating Centre for Acute Care","year":"2007","journal-title":"NICE Clinical Guideline"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.10.056"},{"key":"e_1_2_7_5_2","first-page":"33","article-title":"Epidemiology of fecal incontinence: the silent affliction","volume":"91","author":"Johanson JF","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1997.tb10648.x"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199204093261507"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050307"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)92213-6"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01364.x"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/00365529950173753"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000232504.32589.3b"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4369"},{"issue":"217","key":"e_1_2_7_14_2","first-page":"e1","article-title":"Internal anal sphincter defect influences continence outcome following obstetric anal sphincter injury","volume":"196","author":"Mahony R","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-005-0075-z"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-6-200803180-00210"},{"key":"e_1_2_7_17_2","first-page":"309","article-title":"Risk factors for the development of postnatal anal incontinence","volume":"14","author":"Birch L","year":"2006","journal-title":"BJM"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-005-1338-x"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01553.x"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0660-9"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.02.017"},{"key":"e_1_2_7_22_2","first-page":"321","article-title":"Anal incontinence in primiparas","volume":"23","author":"Farrell SA","year":"2001","journal-title":"J Soc Obstet Gynaecol Can"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-009-0901-2"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000147597.45349.e8"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1999.tb08269.x"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00183.x"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00721.x"},{"key":"e_1_2_7_28_2","first-page":"553","article-title":"Clinical consequences of anal sphincter rupture during vaginal delivery","volume":"183","author":"Fornell EK","year":"1996","journal-title":"J Am Coll Surg"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00400.x"},{"key":"e_1_2_7_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2007.06.001"},{"key":"e_1_2_7_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0b013e3282ef4142"},{"key":"e_1_2_7_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.obstetgynecol.2003.08.021"},{"key":"e_1_2_7_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.22475"},{"key":"e_1_2_7_34_2","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.504"},{"key":"e_1_2_7_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1996.tb09557.x"},{"key":"e_1_2_7_36_2","doi-asserted-by":"publisher","DOI":"10.3109\/00016349709024592"},{"key":"e_1_2_7_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2005.10.014"},{"key":"e_1_2_7_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2001.tb01201.x"},{"key":"e_1_2_7_39_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-005-1351-0"},{"key":"e_1_2_7_40_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000165273.68486.95"},{"key":"e_1_2_7_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.01.032"},{"key":"e_1_2_7_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.04.018"},{"key":"e_1_2_7_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(99)00364-6"},{"key":"e_1_2_7_44_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200005000-00002"},{"key":"e_1_2_7_45_2","first-page":"326","article-title":"Anal incontinence after childbirth","volume":"166","author":"Eason E","year":"2002","journal-title":"CMAJ"},{"key":"e_1_2_7_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00185.x"},{"key":"e_1_2_7_47_2","doi-asserted-by":"crossref","unstructured":"TjandraJJ ChanMK KwokSY YehCH TanJJ SloaneK et alPredictive factors for faecal incontinence after third or fourth degree obstetric tears: a clinico\u2010physiologic study.Colorectal Dis.2008:681\u20138.","DOI":"10.1111\/j.1463-1318.2007.01467.x"},{"key":"e_1_2_7_48_2","doi-asserted-by":"publisher","DOI":"10.1080\/00016340801899008"},{"key":"e_1_2_7_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)34051-8"},{"key":"e_1_2_7_50_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11648.x"},{"key":"e_1_2_7_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.01.013"},{"key":"e_1_2_7_52_2","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2007.05.060222"},{"key":"e_1_2_7_53_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-008-9302-8"},{"key":"e_1_2_7_54_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31816c4433"},{"key":"e_1_2_7_55_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2630"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.3109%2F00016340903576004","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.3109\/00016340903576004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T02:39:19Z","timestamp":1697423959000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.3109\/00016340903576004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3]]},"references-count":54,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2010,3]]}},"alternative-id":["10.3109\/00016340903576004"],"URL":"https:\/\/doi.org\/10.3109\/00016340903576004","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,3]]},"assertion":[{"value":"2010-12-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}