Risk factors for genital prolapse in non-hysterectomized women around menopause - Results from a large cross-sectional study in menopausal clinics inItaly
D. De Aloysio et al., Risk factors for genital prolapse in non-hysterectomized women around menopause - Results from a large cross-sectional study in menopausal clinics inItaly, EUR J OB GY, 93(2), 2000, pp. 135-140
Citations number
22
Categorie Soggetti
Reproductive Medicine
Journal title
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY
Objective: To analyze determinants/risk factors for uterine prolapse in a p
opulation of women around menopause. Methods: Between 1997 and 1999, we con
ducted 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 menopausa
l 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 di
agnosed in 1182 cases (5.5%). Of those, 772 (65.3%) had prolapse degree I a
nd 410 (34.7%) degree II or III. The frequency of uterine prolapse increase
s with age: In comparison with women aged less than or equal to 51 years, t
he odds ratio OR of uterine prolapse was 1.3 and 1.7 respectively for women
aged 52-55 and greater than or equal to 56 years. In comparison with women
with none/primary education, the OR of uterine prolapse was 0.8 (95% confi
dential interval CI 0.7-0.9) and 0.8 (95% CI 0.6-0.9), respectively, for wo
men with intermediate or high school/university degree. The risk of uterine
prolapse increased with body mass index (BMI; kg/m(2)) value: In compariso
n 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 nullip
arae, the OR of uterine prolapse increased with number of births, being 3.0
(95% CI 2.1-4.3) in women reporting greater than or equal to3 births. A hi
story of caesarean section or of a delivery of a fetus weighing >4500 g wer
e not associated with increased risk of uterine prolapse. When the analysis
was conducted separately in strata of grade of uterine prolapse (I and gre
ater than or equal to II), no marked differences emerged in the OR estimate
s. Conclusions: This study indicates that, in this population, the risk of
uterovaginal prolapse increase with the number of vaginal births and was hi
gher in overweight women, offering some quantitative estimates of the role
of these factors on the risk of the condition. (C) 2000 Elsevier Science Ir
eland Ltd. All rights reserved.