Eight studies (N = 2929 women) examining
the relationship between episiotomy and anal incontinence and 12 studies (N = 2288 women) examining the relationship between third- or
fourth-degree perineal laceration and anal incontinence met criteria for inclusion in the meta-analyses. Pooled odds ratios (ORs) demonstrated a
significant association between perineal trauma (episiotomy [OR, 1.74; 95% confidence interval [CI], 1.28-2.38; Q = 8.9; P .26; I2 = 21.4] and
third- or fourth-degree perineal laceration (OR, 2.66; 95% CI, 1.77-3.98; Q = 27.9; P = .002; I2 = 64.1) and anal incontinence.