{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:41:13Z","timestamp":1787013673625,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2014,5,9]],"date-time":"2014-05-09T00:00:00Z","timestamp":1399593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,12]]},"abstract":"\n Objective<\/jats:title>\n To identify the incidence and risk factors of haemorrhoids and fissures during pregnancy and after childbirth.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Prospective observational cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n \n University hospital and outpatient clinics in\n L<\/jats:styled-content>\n ithuania.\n <\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n A total of 280 pregnant women followed up until 1\u00a0month after delivery.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Women were examined four times through pregnancy and after delivery; those that developed peri\u2010anal diseases were compared with those that did not.<\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n Incidence, time and risk factors of haemorrhoids and fissures.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In all, 123 (43.9%) women developed peri\u2010anal disease: 1.6% in the first trimester, 61% during the third trimester, 34.1% after delivery and 3.3% 1\u00a0month 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\u2010nine (80.5%) women had vaginal delivery and 24 (19.5%) women had undergone caesarean section. Multivariate analysis identified personal history of peri\u2010anal diseases (odds ratio [\n OR<\/jats:styled-content>\n ] 11.93; 95% confidence interval [95%\n CI<\/jats:styled-content>\n ] 2.18\u201365.30), constipation (\n OR<\/jats:styled-content>\n 18.98; 95%\n CI<\/jats:styled-content>\n 7.13\u201350.54), straining during delivery for more than 20\u00a0minutes (\n OR<\/jats:styled-content>\n 29.75; 95%\n CI<\/jats:styled-content>\n 4.00\u2013221.23) and birthweight of newborn >3800\u00a0g (\n OR<\/jats:styled-content>\n 17.99; 95%\n CI<\/jats:styled-content>\n 3.29\u201398.49) as significant predictors of haemorrhoids and anal fissures during pregnancy and perinatal period.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Haemorrhoids and fissures are common during the last trimester of pregnancy and 1\u00a0month after delivery, with constipation, personal history of haemorrhoids or fissures, birthweight of newborn >3800\u00a0g, straining during delivery for more than 20\u00a0minutes being independently associated risk factors.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.12838","type":"journal-article","created":{"date-parts":[[2014,5,9]],"date-time":"2014-05-09T03:39:32Z","timestamp":1399606772000},"page":"1666-1671","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study"],"prefix":"10.1111","volume":"121","author":[{"given":"T","family":"Poskus","sequence":"first","affiliation":[{"name":"Centre of Abdominal Surgery Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Buzinskien\u0117","sequence":"additional","affiliation":[{"name":"Clinic of Obstetrics and Gynaecology Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Drasutiene","sequence":"additional","affiliation":[{"name":"Clinic of Obstetrics and Gynaecology Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NE","family":"Samalavicius","sequence":"additional","affiliation":[{"name":"Oncology Institute Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Barkus","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Histology and Anthropology Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Barisauskiene","sequence":"additional","affiliation":[{"name":"Clinic of Obstetrics and Gynaecology Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Tutkuviene","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Histology and Anthropology Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Sakalauskaite","sequence":"additional","affiliation":[{"name":"Clinic of Obstetrics and Gynaecology Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Drasutis","sequence":"additional","affiliation":[{"name":"Clinic of Obstetrics and Gynaecology Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Jasulaitis","sequence":"additional","affiliation":[{"name":"Department of Pathology, Pharmacology and Forensic Medicine Vilnius University Vilnius 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