Reproductive factors, family history, occupation and risk of urogenital prolapse

Objective: We conducted a case-control study to analyze risk factors for ur ogenital prolapse requiring surgery. Methods: Cases were 108 women with a d iagnosis of II or III degree uterovaginal prolapse and/or third degree cyst ocele. Controls were 100 women admitted to the same hospitals as the cases, for acute, non-gynecological, non-neoplastic conditions. Results: Occupati on showed an association with urogenital prolapse: in comparison with profe ssional/managerial women, housewives had an odds ratios (OR) of urogenital prolapse of 3.1 (95% confidence interval (CI), 1.6-8.8). Compared with null iparae, parous women tended to have a higher risk of genital prolapse (OR 2 .6, 95% CI 0.9-7.8). In comparison with women reporting no vaginal delivery , the ORs were 3.0 for women reporting one vaginal delivery (95% CI 1.0-9.5 ), and 4.5 (95% CI 1.6-13.1) for women with two or more vaginal deliveries. Forceps delivery and birthweight were not associated with risk of prolapse after taking into account the effect of number of vaginal deliveries. The risk of urogenital prolapse was higher in women with mother or sisters repo rting the condition: the ORs were, respectively, 3.2 (95% CI 1.1-7.6) and 2 .4 (95% CI 1.0-5.6) in comparison with women whose mother or sisters report ed no prolapse. Conclusions: Our data support the clinical suggestion that parous women are at a higher risk of prolapse and the risk increases with n umber of vaginal deliveries. First-degree family history of prolapse seems to increase the risk of prolapse. (C) 1999 Elsevier Science Ireland Ltd. Al l rights reserved.