Prevalence and Factors Associated with Haemorrhoidal Disease During Pregnancy and the Postpartum Period: A Cross-Sectional Study in Japan

INTRODUCTIONHemorrhoidal disease is common during pregnancy and the postpartum period.Evidence from Japan is limited.This study investigated its prevalence and associated factors among Japanese women.METHODS This cross-sectional study included women aged ≥18 years completing their 1-month postpartum health check-up in Kagawa, Japan.Participants were recruited by convenience sampling from six child-rearing support centers and infant health check-up venues between May and September 2023.Data were self-reported using a questionnaire approximately 1-4 months after childbirth.Postpartum disease was assessed retrospectively from childbirth to questionnaire completion.Multivariable logistic regression was performed separately for pregnancy and postpartum disease.RESULTS Among 292 women, disease occurred in 104/290 (35.9%) during pregnancy and 102 /291 (35.1%) postpartum; and 145 /289 (50.2%) experienced disease during either period.Pre-pregnancy hemorrhoidal disease history was associated with higher odds during pregnancy (AOR=12.60;95% CI: 6.70-23.60;p<0.001).For postpartum disease, this association was attenuated after adjustment for pregnancy disease (AOR=2.16;95% CI: 0.90-5.21;p=0.086), whereas pregnancy disease was associated with more than fourfold higher odds of postpartum disease (AOR=4.24;95% CI: 1.99-9.06;p<0.001).Among women with pregnancy disease, pre-pregnancy history was more common in persistent disease, which was also associated with higher neonatal birth weight.Among women without pregnancy disease, pre-pregnancy history was more common in newonset postpartum disease.CONCLUSIONS Hemorrhoidal disease affected approximately one-third of women during pregnancy and postpartum.Associations were observed across the pre-pregnancy, pregnancy, and postpartum periods, but temporal or causal relationships cannot be established because of the cross-sectional design.