Department of Gynecology, Universidade Federal de São Paulo, Rua Napoleão de Barros, 608 - Vila Clementino, São Paulo, SP, CEP 04024-002, Brazil.
Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
Int Urogynecol J. 2023 Sep;34(9):2007-2032. doi: 10.1007/s00192-023-05569-3. Epub 2023 May 31.
The 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.
Search 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.
Forty-three studies were included in the meta-analysis. BMI < 25 kg/m was found to be a protective factor for POP [OR 0.71 (0.51, 0.99); p = 0.04], and BMI > 30 kg/m 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].
BMI < 25 kg/m is protective while BMI > 30 kg/m is a risk factor for POP. Large waist circumference, dyslipidemia, HT, constipation, occupation, persistent cough, and varicose veins are also determinants for POP.
关于合并症、临床参数和生活方式作为盆腔器官脱垂（POP）风险因素的文献很少。本研究旨在系统地回顾与体重指数（BMI）、腰围、糖尿病（DM）、高血压（HT）、血脂异常、慢性便秘、吸烟、慢性咳嗽、职业、妊娠纹和静脉曲张相关的文献，以确定其是否为 POP 的决定因素。
根据医学主题词在 PubMed、Embase、LILACS 和 Cochrane 图书馆中搜索相关术语。纳入了比较有和无 POP 的女性的临床对照研究，这些研究包含与生活方式和/或合并症相关的人口统计学和/或临床原始数据。使用 ROBINS-I（干预非随机研究的偏倚风险）工具。同质和异质研究分别使用固定效应和随机效应模型。
共有 43 项研究纳入荟萃分析。BMI<25 kg/m 被认为是 POP 的保护因素[OR 0.71（0.51，0.99）；p=0.04]，而 BMI>30 kg/m 是 POP 的危险因素[OR 1.44（1.37，1.52）；p<0.00001]。腰围（≥88 cm）被报道为 POP 的危险因素[OR 1.80（1.37，2.38）；p<0.00001]，同时还与 HT[OR 1.18（1.09，1.27）；p=0.04]、便秘[OR 1.77（1.23，2.54）；p<0.00001]、职业[OR 1.86（1.21，2.86）；p<0.00001]、持续性咳嗽[OR 1.52（1.18，1.94）；p<0.0001]和静脉曲张[OR 2.01（1.50，2.70）；p=0.12]有关。
BMI<25 kg/m 是保护因素，而 BMI>30 kg/m 是 POP 的危险因素。大腰围、血脂异常、HT、便秘、职业、持续性咳嗽和静脉曲张也是 POP 的决定因素。
