Asresie Ayalnesh, Admassu Eleni, Setegn Tesfaye
Hamlin Fistula Center, Amhara National Regional State, Bahir Dar, Ethiopia.
Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Reproductive Health Department, Amhara National Regional State, Bahir Dar, Ethiopia.
Int J Womens Health. 2016 Dec 12;8:713-719. doi: 10.2147/IJWH.S122459. eCollection 2016.
Pelvic organ prolapse (POP) is a significant public health problem in developing countries including Ethiopia. However, less has been documented on risk factors of POP. Therefore, the aim of this study was to identify the determinants factors of POP.
An unmatched case-control study was conducted among gynecologic patients in Bahir Dar city, North West Ethiopia, from July to October 2014. A total of 370 women (selected from outpatient departments) were included in the study. Cases (clients with stage III or IV POP) and controls (who declared free of any stages of POP) were identified by physicians using the Pelvic Organ Prolapse Quantitative Examination tool. Data analysis was carried out by SPSS version 20.0. Descriptive, bivariate, and multivariable logistic regression analyses were performed. Statistical differences were considered at <0.05, and the strength of association was assessed by odds ratio (OR) and respective confidence intervals (CIs).
This study revealed that determinants such as age of women (>40 years) (adjusted OR [AOR] =3.0 [95% CI: 1.59-5.89]), sphincter damage (AOR =8.1 [95% CI: 1.67-39.7]), family history of POP (AOR =4.9 [95% CI: 1.94-12.63]), parity (≥4) (AOR =4.5 [95% CI: 2.26-9.10]), nonattendance of formal education (AOR =4.3 [95% CI: 1.25-14.8]), carrying heavy objects (AOR =3.1 [95% CI: 1.56-6.30]), body mass index (BMI) <18.5 kg/m (AOR =3.1 [95% CI: 1.22-7.82]), and delivery assisted by nonhealth professionals (AOR =2.6 [95% CI: 1.24-5.56]) were significantly associated with POP.
In our study, sphincter damage, family history of POP, being uneducated, having ≥4 vaginal deliveries, carrying heavy objects, BMI <18.5 kg/m, age ≥40 years, and having delivery assisted by nonhealth professional were the independent determinants of POP. Therefore, skilled delivery, further promoting family planning and girls' education, early pelvic floor assessment, and counseling on avoidance of carrying heavy objects are recommended.
盆腔器官脱垂（POP）在包括埃塞俄比亚在内的发展中国家是一个重大的公共卫生问题。然而，关于POP危险因素的文献记载较少。因此，本研究的目的是确定POP的决定因素。
2014年7月至10月，在埃塞俄比亚西北部巴赫达尔市的妇科患者中进行了一项非匹配病例对照研究。共有370名女性（从门诊选出）纳入研究。病例（III期或IV期POP患者）和对照（声明无任何阶段POP的患者）由医生使用盆腔器官脱垂定量检查工具进行识别。数据分析使用SPSS 20.0版进行。进行了描述性、双变量和多变量逻辑回归分析。统计学差异以<0.05为标准，关联强度通过比值比（OR）和相应的置信区间（CI）进行评估。
本研究表明，女性年龄（>40岁）（调整后OR [AOR]=3.0 [95%CI：1.59 - 5.89]）、括约肌损伤（AOR = 8.1 [95%CI：1.67 - 39.7]）、POP家族史（AOR = 4.9 [95%CI：1.94 - 12.63]）、产次（≥4）（AOR = 4.5 [95%CI：2.26 - 9.10]）、未接受正规教育（AOR = 4.3 [95%CI：1.25 - 14.8]）、搬运重物（AOR = 3.1 [95%CI：1.56 - 6.30]）、体重指数（BMI）<18.5 kg/m²（AOR = 3.1 [95%CI：1.22 - 7.82]）以及非卫生专业人员协助分娩（AOR = 2.6 [95%CI：1.24 - 5.56]）等决定因素与POP显著相关。
在我们的研究中，括约肌损伤、POP家族史、未受过教育、有≥4次阴道分娩、搬运重物、BMI<18.5 kg/m²、年龄≥40岁以及非卫生专业人员协助分娩是POP的独立决定因素。因此，建议进行熟练接生、进一步推广计划生育和女童教育、早期盆底评估以及提供避免搬运重物的咨询。
