干旱区生态环境知识资源中心(Arid): Caesarean section and anal incontinence in women after obstetric anal sphincter injury: A systematic review and meta-analysis

Arid

DOI	10.1111/1471-0528.17899
	Caesarean section and anal incontinence in women after obstetric anal sphincter injury: A systematic review and meta-analysis
	Carter, Emily; Hall, Rebecca; Ajoku, Kelechi; Myers, Jenny; Kearney, Rohna
通讯作者	Carter, E
来源期刊	BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
ISSN	1470-0328
EISSN	1471-0528
出版年	2024
英文摘要	BackgroundApproximately 50% women who give birth after obstetric anal sphincter injury (OASI) develop anal incontinence (AI) over their lifetime.ObjectiveTo evaluate current evidence for a protective benefit of planned caesarean section (CS) to prevent AI after OASI.Search StrategyMEDLINE/PubMed, Embase 1974-2024, CINAHL and Cochrane to 7 February 2024 (PROSPERO CRD42022372442).Selection CriteriaAll studies reporting outcomes after OASI and a subsequent birth, by any mode.Data Collection and AnalysisEighty-six of 2646 screened studies met inclusion criteria, with nine studies suitable to meta-analyse the primary outcome of 'adjusted AI' after OASI and subsequent birth. Subgroups: short-term AI, long-term AI, AI in asymptomatic women. Secondary outcomes: total AI, quality of life, satisfaction/regret, solid/liquid/flatal incontinence, faecal urgency, AI in women with and without subsequent birth, change in AI pre- to post- subsequent birth.Main ResultsThere was no evidence of a difference in adjusted AI after subsequent vaginal birth compared with CS after OASI across all time periods (OR = 0.92, 95% CI 0.72-1.20; 9 studies, 2104 participants, I2 = 0% p = 0.58), for subgroup analyses or secondary outcomes. There was no evidence of a difference in AI in women with or without subsequent birth (OR = 1.00 95% CI 0.65-1.54; 10 studies, 970 participants, I2 = 35% p = 0.99), or pre- to post- subsequent birth (OR = 0.79 95% CI 0.51-1.25; 13 studies, 5496 participants, I2 = 73% p = 0.31).ConclusionsDue to low evidence quality, we are unable to determine whether planned caesarean is protective against AI after OASI. Higher quality evidence is required to guide personalised decision-making for asymptomatic women and to determine the effect of subsequent birth mode on long-term AI outcomes.
英文关键词	anal incontinence caesarean faecal incontinence mode of birth OASIS obstetric anal sphincter injury planned birth quality of life recurrent OASI shared decision-making vaginal birth
类型	Review ; Early Access
语种	英语
开放获取类型	hybrid
收录类别	SCI-E
WOS记录号	WOS:001262116800001
WOS关键词	DEGREE PERINEAL TEARS ; SUBSEQUENT PREGNANCY OUTCOMES ; VAGINAL DELIVERY ; RISK-FACTORS ; OASIS ; RECURRENCE ; BIRTH ; MODE ; 3RD ; IMPACT
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/403040
推荐引用方式 GB/T 7714	Carter, Emily,Hall, Rebecca,Ajoku, Kelechi,et al. Caesarean section and anal incontinence in women after obstetric anal sphincter injury: A systematic review and meta-analysis[J],2024.
APA	Carter, Emily,Hall, Rebecca,Ajoku, Kelechi,Myers, Jenny,&Kearney, Rohna.(2024).Caesarean section and anal incontinence in women after obstetric anal sphincter injury: A systematic review and meta-analysis.BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY.
MLA	Carter, Emily,et al."Caesarean section and anal incontinence in women after obstetric anal sphincter injury: A systematic review and meta-analysis".BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY (2024).