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盆腔器官脱垂:巴西人群中的患病率及危险因素

Pelvic organ prolapse: prevalence and risk factors in a Brazilian population.

作者信息

Horst Wagner, do Valle Juliana Barros, Silva Jean Carl, Gascho Carmem Luíza Lucht

机构信息

Postgraduation program in Health and Environment, University of the Region of Joinville (Univille), Joinville, Brazil.

, Rua Barão do Rio Branco, 207 sala 7, Jaraguá do Sul, Brazil, 89251-400.

出版信息

Int Urogynecol J. 2017 Aug;28(8):1165-1170. doi: 10.1007/s00192-016-3238-7. Epub 2016 Dec 29.

Abstract

INTRODUCTION AND HYPOTHESIS

Although pelvic organ prolapse (POP) is a prevalent condition among Brazilians, population-based epidemiological studies of POP are scarce. We studied POP in a population of women undergoing routine examination to determine its prevalence, distribution and relationship to risk factors.

METHODS

This quantitative descriptive study surveyed 432 women, based on prolapse prevalence, who sought routine care and were assessed for prolapse staging using the Pelvic Organ Prolapse Quantification system (POP-Q). Demographics, health history, socioeconomic data, symptoms and risk factors for prolapse were self-reported by the participants.

RESULTS

A total of 226 (52.3%) of the examined women had POP. The prevalences of POP in relation to stage were as follows: stage 1 (27.8%), stage 2 (23.1%), and stage 3 (1.4%). Regarding risk factors, a history of vaginal delivery (odds ratio, OR, 6.678, 95% confidence interval, CI, 4.16-10.73), delivery of a newborn heavier than 4 kg (OR 2.056, 95% CI 1.19-3.56) and menopausal status (OR 2.793, 95% CI 1.66-4.70) were all associated with a higher risk of prolapse.

CONCLUSIONS

We found that a majority of the population sample exhibited some degree of prolapse, suggesting that POP deserves substantial clinical attention. The risk factors identified suggest that eventual prolapse may be unavoidable in some women. Public policies should be implemented with respect to modifiable risk factors and antenatal care.

摘要

引言与假设

尽管盆腔器官脱垂(POP)在巴西人群中普遍存在,但基于人群的POP流行病学研究却很匮乏。我们对接受常规检查的女性群体进行了POP研究,以确定其患病率、分布情况以及与风险因素的关系。

方法

这项定量描述性研究调查了432名女性,根据脱垂患病率,这些女性寻求常规护理,并使用盆腔器官脱垂定量系统(POP-Q)对脱垂进行分期评估。参与者自行报告人口统计学、健康史、社会经济数据、症状和脱垂风险因素。

结果

共有226名(52.3%)接受检查的女性患有POP。POP各阶段的患病率如下:1期(27.8%)、2期(23.1%)和3期(1.4%)。关于风险因素,阴道分娩史(优势比,OR,6.678,95%置信区间,CI,4.16 - 10.73)、分娩体重超过4千克的新生儿(OR 2.056,95% CI 1.19 - 3.56)和绝经状态(OR 2.793,95% CI 1.66 - 4.70)均与较高的脱垂风险相关。

结论

我们发现大多数人群样本存在一定程度的脱垂,这表明POP值得临床高度关注。所确定的风险因素表明,在某些女性中最终发生脱垂可能不可避免。应针对可改变的风险因素和产前护理实施公共政策。

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