PEOPLE: Lifestyle and comorbidities as risk factors for pelvic organ prolapse-a systematic review and meta-analysis PEOPLE: PElvic Organ Prolapse Lifestyle comorbiditiEs

Author(s)

Fitz, Fatima Fani ; Bortolini, Maria Augusta Tezelli ; Pereira, Glaucia Miranda Varella ; Salerno, Gisela Rosa Franco ; Castro, Rodrigo Aquino

• Document type: Journal article
• Source: INTERNATIONAL UROGYNECOLOGY JOURNAL; v. 34, n. 9, p. 26-pg., 2023-05-31.

Abstract

Introduction and hypothesisThe literature is scarce regarding the effects of comorbidities, clinical parameters, and lifestyle as risk factors for pelvic organ prolapse (POP). This study was performed to systematically review the literature related to body mass index (BMI), waist circumference, diabetes mellitus (DM), hypertension (HT), dyslipidemia, chronic constipation, smoking, chronic cough, occupation, and striae and varicose veins as determinants for POP.MethodsSearch terms in accordance with Medical Subject Headings were used in PubMed, Embase, LILACS, and the Cochrane Library. Clinical comparative studies between women with and without POP and containing demographic and/or clinical raw data related to lifestyle and/or comorbidities were included. The ROBINS-I (risk of bias in non-randomized studies of interventions) instrument was used. Fixed-effects and random-effects models were used for homogeneous and heterogeneous studies, respectively.ResultsForty-three studies were included in the meta-analysis. BMI < 25 kg/m(2) was found to be a protective factor for POP [OR 0.71 (0.51, 0.99); p = 0.04], and BMI > 30 kg/m(2) was a risk factor for POP [OR 1.44 (1.37, 1.52); p < 0.00001]. Waist circumference (>= 88 cm) was reported as a risk factor for POP [OR 1.80 (1.37, 2.38); p < 0.00001], along with HT [OR 1.18 (1.09, 1.27); p = 0.04], constipation [OR 1.77 (1.23, 2.54); p < 0.00001], occupation [OR 1.86 (1.21, 2.86); p < 0.00001], persistent cough [OR 1.52 (1.18, 1.94); p < 0.0001]), and varicose veins [OR 2.01 (1.50, 2.70); p = 0.12].ConclusionsBMI < 25 kg/m(2) is protective while BMI > 30 kg/m(2) is a risk factor for POP. Large waist circumference, dyslipidemia, HT, constipation, occupation, persistent cough, and varicose veins are also determinants for POP. (AU)

• FAPESP's process: 19/26723-5 - Effect of fractional microablative radiofrequency and pelvic floor muscle training in the treatment of women with of vaginal laxity: randomized clinical trial
• Grantee: Glaucia Miranda Varella Pereira
• Support Opportunities: Scholarships in Brazil - Doctorate