Prevalence and Associated Factors of Hemorrhoids and Other Perianal Complications During the Puerperium Among Mothers Who Gave Birth at Debre Tabor Referral Hospital, Debre Tabor, Ethiopia, 2022

Abstract

Puerperium is defined as the period of six weeks after childbirth during which the mother’s reproductive organs return to their original non-pregnant condition. Perianal problems, including constipation, hemorrhoids, and fissures, are among the most common complications among women during the puerperium, observed in about 30 to 50 percent of women. Considering this great prevalence and the paucity of similar research in Ethiopia, this study was done to assess the prevalence of perianal problems during the puerperium and the risk factors associated with them. METHODS: An institution-based cross-sectional study was conducted from February 1 to April 30, 2022. Quota sampling technique was used to select a total of 191 participants. The data were collected and then entered using EPI DATA version 3.1 and exported to STATA 14 for analysis. Bivariable and multivariable logistic regression analyses were performed. Adjusted odds ratio (AOR) with 95% confidence interval was used as a measure of association. Variables having a P-value < 0.05 from the multivariable analysis were considered to have a significant association with the outcome. RESULTS: The total prevalence of all the perianal problems in the puerperium encountered in this study was 22.5% (43 mothers). The perianal problems encountered were fissure [9.4%], followed by hemorrhoids [7.3%], peri-anal episiotomy infections (4.2%), and peri-anal tears (1.6%). Comparative analysis showed that positive family history, past history of perianal diseases, and prolonged second stage of labor (>50 minutes) showed a higher prevalence in the perianal disease group as compared to the healthy group. A statistically significant relationship was observed between the prevalence of hemorrhoids and a past history of any perianal disease [p=0.04]. A statistically significant relationship was observed between the prevalence of hemorrhoids and parity [p=0.02]. There was also a statistically significant relationship between constipation during pregnancy and the development of hemorrhoids [p=0.01]. CONCLUSION: Anal fissure, hemorrhoids, and perianal episiotomy infections are the most common perianal problems in the postpartum period, causing a significant reduction in the quality of life of those afflicted with them.