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Objective: To evaluate risk factors for anal incontinence using an identical twin sisters study design to provide control over genetic variance. Methods: A total of identical twin sister pairs mean age 47 years completed the validated Colorectal Anal Distress Inventory questionnaire detailing the presence and severity of anal incontinence. Data were analyzed using a stepwise logistic regression with repeated binary measures to account for correlated data within twin pairs. Three different statistical models were used to analyze nonobstetric as well as obstetric risk factors separately. Results: Significant risk factors for anal incontinence and higher Colorectal Anal Distress Inventory anal incontinence subscale scores included age 40 years or older fecal: odds ratio [OR] 2.
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