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

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 82; no. 1; pp. 63 - 67
• Main Authors: Chiaffarino, F, Chatenoud, L, Dindelli, M, Meschia, M, Buonaguidi, A, Amicarelli, F, Surace, M, Bertola, E, Di Cintio, E, F. Parazzini
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 1999; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Birth Weight; Case-Control Studies; Confidence Intervals; Estrogen Replacement Therapy; Family; Female; Female genital diseases; Genital prolapse; Gynecology. Andrology. Obstetrics; Humans; Interviews as Topic; Italy - epidemiology; Medical sciences; Middle Aged; Non tumoral diseases; Obstetrical Forceps - adverse effects; Occupations; Odds Ratio; Parity; Reproductive factors; Reproductive History; Risk Factors; Smoking; Social Class; Surveys and Questionnaires; Uterine Prolapse - epidemiology; Uterine Prolapse - etiology; Uterine Prolapse - surgery; Italy; Genital prolapse; Risk factors; Reproductive factors; Human; Urinary system disease; Vagina; Vaginal diseases; Urinary tract disease; Case control study; Statistical study; Female genital diseases; Pregnancy; Prolapsus; Profession; Vaginal route; Cystocele; Uterus; Risk factor; Uterine diseases; Family environment; Female; Bladder disease; Delivery
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/S0301-2115(98)00175-4

Objective: We conducted a case–control study to analyze risk factors for urogenital prolapse requiring surgery.
Methods: Cases were 108 women with a diagnosis of II or III degree uterovaginal prolapse and/or third degree cystocele. Controls were 100 women admitted to the same hospitals as the cases, for acute, non-gynecological, non-neoplastic conditions.
Results: Occupation showed an association with urogenital prolapse: in comparison with professional/managerial women, housewives had an odds ratios (OR) of urogenital prolapse of 3.1 (95% confidence interval (CI), 1.6–8.8). Compared with nulliparae, 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 reporting 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 reported no prolapse.
Conclusions: Our data support the clinical suggestion that parous women are at a higher risk of prolapse and the risk increases with number of vaginal deliveries. First-degree family history of prolapse seems to increase the risk of prolapse.