From the University of Chicago Pritzker School of Medicine.
Department of Obstetrics and Gynecology, University of Chicago.
Female Pelvic Med Reconstr Surg. 2021 Mar 1;27(3):147-150. doi: 10.1097/SPV.0000000000001016.
Prior literature has suggested a decreased prevalence of pelvic organ prolapse (POP) in Black women. We sought to describe POP rates by race, investigate whether specific types of prolapse differ based on race, and investigate the role of uterine weight and fibroids on POP.
We conducted a retrospective cohort study of new patients seen between April 2017 and April 2019 at a tertiary urogynecology clinic. Variables collected included POP quantification, race, age, smoking history, medical history, gravity, parity, vaginal delivery, hysterectomy, fibroids, and uterine weight. χ2 tests were used to compare the proportions of types of POP between Black and non-Black women. Binary and ordinal logistic regression tested the association between types of prolapse and race, adjusting for covariates.
Nine hundred thirty-six patients were identified by ICD codes, 768 met inclusion criteria. There were 85.3% of the women identified as non-Black and 14.7% identified as Black. There were 39.8% of the Black women that had a fibroid diagnosis compared with 20.8% of non-Black women (P < 0.001). Black women had a higher median uterine weight, 112.2 g versus 56 g (P = 0.002), and median fibroid size, 3.4 cm versus 1.92 cm (P = 0.0001). 56.9% of women presented with anterior prolapse. No difference was found in POP type between Black and non-Black women after adjusting for age, body mass index, parity, and delivery route (P = 0.45).
Black women had increased body mass index, rates of comorbidities (diabetes and hypertension), higher uterine weight and fibroid size than non-Black women in our study. However, there was no significant difference in POP type based on race.
先前的文献表明黑人女性中盆腔器官脱垂（POP）的患病率较低。我们旨在描述按种族划分的 POP 发生率，调查特定类型的脱垂是否因种族而异，并研究子宫重量和肌瘤对 POP 的影响。
我们对 2017 年 4 月至 2019 年 4 月在一家三级泌尿科妇科诊所就诊的新患者进行了回顾性队列研究。收集的变量包括 POP 定量、种族、年龄、吸烟史、病史、体重、产次、阴道分娩、子宫切除术、肌瘤和子宫重量。χ2 检验用于比较黑人和非黑人女性中各种类型 POP 的比例。二元和有序逻辑回归检验了调整协变量后，脱垂类型与种族之间的关联。
根据 ICD 编码确定了 936 名患者，符合纳入标准的有 768 名。女性中黑人占 14.7%，非黑人占 85.3%。黑人中有 39.8%的女性被诊断为患有肌瘤，而非黑人中有 20.8%（P < 0.001）。黑人女性的子宫重量中位数为 112.2g，而非黑人女性为 56g（P = 0.002），肌瘤大小中位数为 3.4cm，而非黑人女性为 1.92cm（P = 0.0001）。56.9%的女性出现前位脱垂。调整年龄、体重指数、产次和分娩方式后，黑人与非黑人女性的 POP 类型无差异（P = 0.45）。
在我们的研究中，与非黑人女性相比，黑人女性的体重指数、合并症（糖尿病和高血压）发生率更高，子宫重量和肌瘤更大。然而，基于种族，POP 类型没有显著差异。
