BACKGROUND: Primiparous @entity1 have an increased risk of @entity130 ; because most of these @entity1 deliver again, there are major concerns about mode of delivery: the risk of recurrent @entity130 and the risk of long-term symptoms of anal @entity322 . Although an elective cesarean delivery protects against recurrent @entity130 , it is uncertain how the second delivery affects the risk of long-term anal @entity322 . OBJECTIVE: The purpose of this study was to evaluate whether the mode of delivery for a second pregnancy, after a documented @entity130 at the time of first delivery, had a significant impact on the prevalence of anal and @entity1241 in the long term. STUDY DESIGN: We performed a population-based questionnaire cohort study that evaluated anal and @entity1241 , fecal urgency, and affected quality of life caused by anal @entity322 in 1978 @entity1 who had @entity130 in the first delivery and a second vaginal (n  = 1472 @entity1 ; 71.9%) or elective cesarean delivery (n  = 506 @entity1 ; 24.7%) delivery. We performed uni- and multivariable logistic regression analyses to compare groups. RESULTS: Long-term anal @entity322 was reported in 38.9% of @entity1 (n  = 573) with second vaginal compared with 53.2% (n  = 269) with elective cesarean delivery. The corresponding numbers that reported anal @entity322 before the second pregnancy was 29.4% for those with  vaginal delivery compared with 56.2% of those with elective cesarean delivery (ie, there was a significantly larger change in the risk of anal @entity322 in the group with a second vaginal delivery compared with the change in the group with elective cesarean in second delivery). However, adjusted for important maternal and obstetric characteristics, the risk of long-term anal @entity322 was nonsignificantly lower in @entity1 with elective cesarean delivery (adjusted odds ratio, 0.77; 95%  confidence interval, 0.57-1.05; P  = .09). Furthermore, the risk of @entity1241 was not affected by mode of delivery in the multivariable analysis (adjusted odds ratio, 1.04; 95% confidence interval, 0.76-1.43; P  = .79). @entity1 with persistent anal @entity322 before the second  pregnancy (n  = 496) had an increased risk of long-term anal @entity322 (adjusted odds ratio, 64.70; 95% confidence interval, 42.85-97.68; P < .001) and long-term @entity1241 (adjusted odds ratio, 13.76, 95% confidence interval, 10.03-18.88, P<0.001) compared with @entity1 without anal @entity322 before the second pregnancy. CONCLUSION: Mode of second delivery did not significantly affect the risk of long-term anal or @entity1241 in multivariable analyses of @entity1 with previous @entity130 in this population in which @entity1 with anal @entity322 before the second pregnancy were recommended to have an elective cesarean delivery in the subsequent delivery. Nonetheless, we found that @entity1 with vaginal delivery had a higher risk of deterioration of anal @entity322 symptoms compared with those with an elective cesarean delivery.

Mode of delivery after XXXX and the risk of long-term anal @entity322 .

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients'] @entity1241 :: ('MESH:D005242', 'Disease') :: ['fecal incontinence'] @entity322 :: ('MESH:D014549', 'Disease') :: ['incontinence'] @entity130 :: ('MESH:D014947', 'Disease') :: ['obstetric anal sphincter injury']
@entity130 :: (MESH:D014947,Disease) :: ['obstetric anal sphincter injury']
