Hemorrhoids, Anorectal Symptoms, and Related Risk Factors in Pregnancy and the Postpartum Period: A Follow-up Study

Abstract

Purpose: To investigate the presence of hemorrhoids and anorectal signs/symptoms and to identify various risk factors including anthropometric/musculoskeletal contributors associated with hemorrhoids in pregnancy and the postpartum period. Background: Pregnancy and the postpartum period may predispose women to develop hemorrhoids and anorectal symptoms because of hormonal and musculoskeletal changes. Methods: Fifty-one pregnant women with no history of anorectal disease were included in the study. The occurrence of hemorrhoids and other anorectal signs/symptoms was examined at 4 different times: first, second, and third trimesters, and postpartum 6th week. The Rome III criteria and the Bristol Stool Scale were used to confirm the presence of constipation and to determine stool type, respectively. Waist and hip circumference (as anthropometric contributors), bi-iliac and bitrochanteric width (as diameter measurements), diastasis recti abdominis, joint hypermobility, and lumbar lordosis (as musculoskeletal contributors) were evaluated. Personal, demographic, and clinical characteristics of the patients as well as postpartum period information were also recorded. Results: Hemorrhoids, perianal discomfort, perianal pain, and protrusion were significantly more frequent at postpartum than at the first trimester (P < .008). According to the multivariate analysis, body mass index, the presence of constipation, joint hypermobility, and birth weight were significant determinants of hemorrhoids at the third trimester and postpartum (odds ratio = 1.25-2.67). Conclusions: Body mass index, constipation, joint hypermobility, and increased birth weight of the newborn were potential risk factors for the development of hemorrhoids during pregnancy and postpartum. Hemorrhoids and anorectal complaints should be kept in mind and managed to increase the quality of life during pregnancy and the postpartum period.