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Risk factors for genital prolapse in non-hysterectomized women around menopause: Results from a large cross-sectional study in menopausal clinics in Italy
Ist Teil von
European journal of obstetrics & gynecology and reproductive biology, 2000, Vol.93 (2), p.135-140
Ort / Verlag
Shannon: Elsevier Ireland Ltd
Erscheinungsjahr
2000
Quelle
Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)
Beschreibungen/Notizen
Objective: To analyze determinants/risk factors for uterine prolapse in a population of women around menopause.
Methods: Between 1997 and 1999, we conducted a large cross sectional study on the characteristics of women around menopause attending a network of first level outpatients menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. Eligible for the study were women consecutively observed during the study period. All women underwent a gynecological examination.
Results: Considering the 21 449 non-hysterectomized women, uterine prolapse was diagnosed in 1182 cases (5.5%). Of those, 772 (65.3%) had prolapse degree I and 410 (34.7%) degree II or III. The frequency of uterine prolapse increases with age: In comparison with women aged ≤51 years, the odds ratio
OR of uterine prolapse was 1.3 and 1.7 respectively for women aged 52–55 and ≥56 years. In comparison with women with none/primary education, the
OR of uterine prolapse was 0.8 (95% confidential interval
CI 0.7–0.9) and 0.8 (95%
CI 0.6–0.9), respectively, for women with intermediate or high school/university degree. The risk of uterine prolapse increased with body mass index (
BMI; kg/m
2) value: In comparison with women with
BMI<23.8, the
OR was 1.4 (95%
CI 1.2–1.7) and 1.6 (95%
CI 1.3–1.9) for women with
BMI 23.8–27.2 and >27.2. In comparison with nulliparae, the
OR of uterine prolapse increased with number of births, being 3.0 (95%
CI 2.1–4.3) in women reporting ≥3 births. A history of caesarean section or of a delivery of a fetus weighing >4500 g were not associated with increased risk of uterine prolapse. When the analysis was conducted separately in strata of grade of uterine prolapse (I and ≥II), no marked differences emerged in the
OR estimates.
Conclusions: This study indicates that, in this population, the risk of uterovaginal prolapse increase with the number of vaginal births and was higher in overweight women, offering some quantitative estimates of the role of these factors on the risk of the condition.