Details

Autor(en) / Beteiligte

• Giri, Ayush, MS, PhD
• Hartmann, Katherine E., MD, PhD
• Hellwege, Jacklyn N., PhD
• Velez Edwards, Digna R., PhD, MS
• Edwards, Todd L., PhD, MS

Titel

Obesity and pelvic organ prolapse: a systematic review and meta-analysis of observational studies

Ist Teil von

• American journal of obstetrics and gynecology, 2017-07, Vol.217 (1), p.11-26.e3

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Background Studies evaluating the association between obesity and pelvic organ prolapse (POP) report estimates that range from negative to positive associations. Heterogeneous definitions for POP and variable choices for categorizing obesity measures have made it challenging to conduct meta-analysis. Objective We systematically evaluated evidence to provide quantitative summaries of association between degrees of obesity and POP, and identify sources of heterogeneity. Evidence acquisition and method of synthesis We searched for all indexed publications relevant to POP up until June 18, 2015 in PubMed/Medline to identify analytical observational studies published in English that reported risk ratios (relative risk, odds ratio or hazard ratio) for body mass index (BMI) categories in relation to POP. Random-effects meta-analyses were conducted to report associations with POP for overweight and obese BMI categories compared with women in the normal-weight category (referent: BMI <25 kg/m2 ). Results Of the seventy studies that reported evidence on obesity and POP, 22 eligible studies provided effect estimates for meta-analysis of the overweight and obese BMI categories. Compared with the referent category, women in the overweight and obese categories had meta-analysis risk ratios of at least 1.36 (95% confidence interval [CI]: 1.20, 1.53) and at least 1.47 (95% CI: 1.35, 1.59), respectively. Subgroup analyses showed effect estimates for objectively-measured clinically-significant POP were higher than for self-reported POP. Other potential sources of heterogeneity included proportion of post-menopausal women in study and reported study design. Conclusions Overweight and obese women are more likely to have POP compared with women with BMI in the normal range. The finding that the associations for obesity measures were strongest for objectively-measured, clinically-significant POP further strengthens this evidence. However, prospective investigations evaluating obesity and POP are few.