Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. (9th May 2014)

• Record Type: Journal Article
• Authors: Poskus, T; Buzinskienė, D; Drasutiene, G; Samalavicius, NE; Barkus, A; Barisauskiene, A; Tutkuviene, J; Sakalauskaite, I; Drasutis, J; Jasulaitis, A; Jakaitiene, A
• Is Part Of: BJOG. Volume 121:Number 13(2014)
• Page Start: 1666
• Page End: 1671
• Publication Date: 2014-05-09
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12838
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo12838-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12838-sec-0001" sec-type="section"> <title>Objective</title> <p>To identify the incidence and risk factors of haemorrhoids and fissures during pregnancy and after childbirth.</p> </sec> <sec id="bjo12838-sec-0002" sec-type="section"> <title>Design</title> <p>Prospective observational cohort study.</p> </sec> <sec id="bjo12838-sec-0003" sec-type="section"> <title>Setting</title> <p>University hospital and outpatient clinics in Lithuania.</p> </sec> <sec id="bjo12838-sec-0004" sec-type="section"> <title>Population</title> <p>A total of 280 pregnant women followed up until 1 month after delivery.</p> </sec> <sec id="bjo12838-sec-0005" sec-type="section"> <title>Methods</title> <p>Women were examined four times through pregnancy and after delivery; those that developed peri‐anal diseases were compared with those that did not.</p> </sec> <sec id="bjo12838-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Incidence, time and risk factors of haemorrhoids and fissures.</p> </sec> <sec id="bjo12838-sec-0007" sec-type="section"> <title>Results</title> <p>In all, 123 (43.9%) women developed peri‐anal disease: 1.6% in the first trimester, 61% during the third trimester, 34.1% after delivery and 3.3% 1 month after delivery; 114 (40.7%) women were diagnosed with haemorrhoids, seven (2.5%) with haemorrhoids and anal fissure and two (0.71%) with anal fissure. Ninety‐nine (80.5%) women had vaginal delivery and 24 (19.5%) women had undergone caesarean section. Multivariate analysis identified personal history of peri‐anal diseases (odds ratio [OR] 11.93; 95% confidence interval [95% CI] 2.18–65.30), constipation (OR 18.98; 95% CI 7.13–50.54), straining during delivery for more than 20 minutes (OR 29.75; 95% CI 4.00–221.23) and birthweight of newborn >3800 g (OR 17.99; 95% CI 3.29–98.49) as significant predictors of haemorrhoids and anal fissures during pregnancy and perinatal period.</p> </sec> <sec id="bjo12838-sec-0008" sec-type="section"> <title>Conclusions</title> <p>Haemorrhoids and fissures are common during the last trimester of pregnancy and 1 month after delivery, with constipation, personal history of haemorrhoids or fissures, birthweight of newborn >3800 g, straining during delivery for more than 20 minutes being independently associated risk factors.</p> </sec> </abstract>