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. 2023 Sep 13;15(9):e45144.
doi: 10.7759/cureus.45144. eCollection 2023 Sep.

Determination of Normal Anal Position Using the Anal Position Index in Pakistani Neonates

Areej Salim  1 , Muhammad Awais Kanwal  2 , Zainab Haji  3 , Kashaf Turk  1 , Yusra Tariq  1 , Umaisa Khalid  2 , Muhammad Arif Mateen Khan  1
Affiliations

Determination of Normal Anal Position Using the Anal Position Index in Pakistani Neonates

Areej Salim et al. Cureus. .

Abstract

Introduction: Anterior displacement of the anus (ADA) is recognized as a common congenital abnormality of the anorectal region and is often associated with constipation. It is diagnosed through a physical examination by measuring the Anal Position Index (API) at birth.

Methods: A cross-sectional study was conducted utilizing non-probability consecutive sampling of all patients presenting with ADA at our institute over a six-month period. The study focused on key variables, including the measurement of scroto-anal and scroto-coccygeal distances in boys and fourchette-anal and fourchette-coccygeal distances in girls. Data collection was carried out using a structured proforma, ensuring prospective data collection from neonates meeting the selection criteria (neonates born at our center and identified by the neonatology team as having a normal anal opening, regardless of their gestational period or birthweight).

Results: Our study comprised a cohort of 204 neonates. The Anal Position Index was determined to be 0.36 ± 0.07 for male newborns and 0.24 ± 0.06 for female newborns. Notably, a statistically significant correlation was observed between the API and factors such as gestational age, birth weight, and advancing paternal age.

Conclusion: The assessment of the API proves highly valuable in identifying indicators of ADA in neonates, facilitating early disease detection, and guiding the prompt management of subsequent functional symptoms, such as constipation, during later stages of life.

Keywords: ada; anal position index; anterior displacement of anus; api; normal anal position; pakistani neonates; pediatric surgery.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Detailed subgroup analysis.
Figure 2
Figure 2. Measurement of anal position index
Figure 3
Figure 3. Measuring the inferior border of the coccyx, the middle of the anus, and the fourchette/the first fold of the scrotum.
See this image and copyright information in PMC

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