约旦女性盆腔器官脱垂的预测因素及生活质量：一项病例对照研究。
Predictive Factors of Pelvic Organ Prolapse and the Quality of Life Among Jordanian Women: A Case-Control Study.
作者信息
Qatawneh Ayman, Qudah Shrouq, Alkouz Dania, Kadah Abdulla, Abu Salma Baha'a, Al-Alawneh Waed, Alhabosh Sara, Salahaldeen Majed, Banihamad Balqees Aref, Aldmour Bara'a Amer, Alkouz Noor, Alqatawneh Abdulrahman, Muhaidat Nadia, Thekrallah Fida, Abufaraj Mohammad
机构信息
Department of Obstetrics and Gynecology, Jordan University Hospital, The University of Jordan, Amman, Jordan.
Faculty of Medicine, The University of Jordan, Amman, Jordan.
出版信息
Int J Womens Health. 2025 Jul 24;17:2299-2311. doi: 10.2147/IJWH.S519065. eCollection 2025.
BACKGROUND
Pelvic organ prolapse (POP) is a common gynecological problem. Several risk factors have been identified to contribute to the main pathophysiological mechanism of prolapse development. However, the POP data in the Eastern Mediterranean region, including Jordan, are limited, and the risk factors associated with POP were mainly obesity and high number of vaginal deliveries. Since Jordan has a high prevalence of obesity, parity, and type 2 diabetes, the present study aimed primarily to identify the modifiable and non-modifiable factors associated with POP in Jordanian women, and secondly, to evaluate the impact of POP stages on their quality of life.
METHODS
This study was an age-matched case-control study conducted at the gynecology outpatient clinics at Jordan University Hospital from March 1, 2022, to December 15, 2022. The POP quantification system was used as a standardized method to identify the cases and controls. Sociodemographic, obstetrics, and gynecological characteristics were obtained and correlated with POP. Multivariable logistic regression was performed to determine the independent predictive factors of prolapse occurrence. The Prolapse Quality of Life questionnaire was employed to assess the impact of prolapse across the stages of prolapse.
RESULTS
One hundred fifty cases and 150 controls were enrolled in this study, with a median age of 44.5 years. Cystocele and rectocele were the most identified types of prolapse. Nearly 65% of women reported that they had an episiotomy during their deliveries, and 14% reported that there was a family history of prolapse. Multivariable logistic regression revealed that obesity (AOR = 2.31, 95% CI 1.07-5.84, p = 0.03), episiotomy (AOR = 2.88, 95% CI 1.41-5.89, p = 0.004) and family history of prolapse (AOR = 3.45, 95% CI 1.3-9.2, p = 0.013) were associated with POP. Impairment in the quality of life was significantly higher across prolapse severity stages.
CONCLUSION
In Jordan, obesity, episiotomy, and a family history were associated with POP. Quality of life for women with POP was notably impaired as the severity of the prolapse increased.
背景
盆腔器官脱垂（POP）是一种常见的妇科问题。已确定有几个风险因素导致脱垂发生的主要病理生理机制。然而，包括约旦在内的东地中海地区的POP数据有限，与POP相关的风险因素主要是肥胖和阴道分娩次数多。由于约旦肥胖、经产和2型糖尿病的患病率较高，本研究主要旨在确定约旦女性中与POP相关的可改变和不可改变因素，其次，评估POP分期对其生活质量的影响。
方法
本研究是一项年龄匹配的病例对照研究，于2022年3月1日至2022年12月15日在约旦大学医院的妇科门诊进行。采用POP量化系统作为识别病例和对照的标准化方法。获取社会人口统计学、产科和妇科特征，并将其与POP进行关联。进行多变量逻辑回归以确定脱垂发生的独立预测因素。采用脱垂生活质量问卷评估脱垂各阶段的影响。
结果
本研究共纳入150例病例和150例对照，中位年龄为44.5岁。膀胱膨出和直肠膨出是最常见的脱垂类型。近65%的女性报告她们在分娩时有会阴切开术，14%的女性报告有脱垂家族史。多变量逻辑回归显示，肥胖（优势比[AOR]=2.31，95%置信区间[CI]1.07 - 5.84，p = 0.03）、会阴切开术（AOR = 2.88，95% CI 1.41 - 5.89，p = 0.004）和脱垂家族史（AOR = 3.45，95% CI 1.3 - 9.2，p = 0.013）与POP相关。随着脱垂严重程度的增加，生活质量受损显著更高。
结论
在约旦，肥胖、会阴切开术和家族史与POP相关。随着脱垂严重程度的增加，POP女性的生活质量明显受损。
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