Study On The Prevalence And The Influence Factors Of Female Pelvic Organ Prolapse In Gansu Province

Objective To estimate the prevalence of female pelvic organ prolapse(POP)in Gansu province.To explore risk factors involved in POP according to study the correlation between POP and demographic data,obstetric factors(history of childbirth,delivery mode,parity and maximal fetal weight).To provide scientific evidence for making preventive measures against POP.Methods According to the local demographic distribution characteristics,with stratified cluster sampling,6 districts(Lanzhou,Tianshui,Jinchang,Baiyin,Jingning,Yongchang)in Gansu province were enrolled.A cross sectional survey between February 2014 and October 2015,was conducted in 3~5 communities/countries of every district,according to the questionnaire,which conveyed demographic characteristics,obstetric factors(history of childbirth,delivery mode,parity and maximal fetal weight),chronic disease(chronic constipation,chronic cough,hypertension,diabetes mellitus).POP was assessed according to stage Ⅱand greater in Pelvic organ prolapse Quantification(POP-Q).We selected eligible patients with POP were selected and compared to a control group of eligible women who were matched with regard to age±1at the ratio of 1 to 2,were included in a case-control study in order to identify associated risk factors for POP,according to conditional Logistical stepwise regress analysis.Results1.The overall prevalence of POP was 19.31% for adult women(≥20 years)in Gansu province,with a prevalence of 16.38% in stage Ⅱ,2.94% in stage Ⅲ and greater.In terms of types of POP,the multicompartment prolapse is most prevalent(8.81%),while middle compartment prolapse is least(0.62%).The prevalence of prolapse in 6 different districts was following in a descending order: Lanzhou(26.3%),Jingning(24.84%),Yongchang(20.67%),Jinchang(15.45%),Baiyin(11.33%),Tianshui(7.13%).The prevalence rate of women in the 50~59age group reached top(29.18%).The prevalence of POP in cities increased with aging(Ptrend<0.05).2.In terms of types of POP,the multicompartment prolapse is most prevalent(8.81%),while middle compartment prolapse is least(0.62%).the prevalence of anterior compartment prolapse for women was increasing with aging.With women’s BMI or babies’ weight getting advanced,the prevalence of multiple-compartment POP increased.3.Multivariate analysis which enrolled the significant factors from uni-variable analysis revealed that: Women living in country(OR:1.469,95%CI:1.277-1689),being overweight(OR:1.321,95%CI:1.157-1.508)or obese(OR:1.441,95%CI:1.108-1.874),childbirth(OR:2.136,95%CI: 1.149-3972),parity≥2(OR:1.193,95%CI:1.041-1.368),history of delivering macrosomia(OR:1.385,95%CI:1.087-1.763),assisted delivery(OR:1.827,95%CI:1.119-2.983),chronic constipation(OR: 2.246,95%CI:1.879-2.686),chronic cough(OR:1.861,95%CI: 1.493-2.321)and hypertension(OR: 1.200,95%CI: 1.019-1.412)contributed to POP.4.Stratified analysis revealed: there were different risks of developing POP between urban and rural women who were both had a history of delivery,so did women who had delivered macrosomia,In parity-stratified analysis model,different delivery modes were at different risks of developing POP.Women of parity=1 in different delivery modes were at statistically significant different risks of developing POP,but not for women of parity=2.Conclusions1.The prevalence of POP was 19.31% for adult women of ≥20 years old in Gansu province,reaching a higher level in China.Women of 50-60 years old(29.18%),living in Lanzhou district(26.30%)had highest prevalence.So did rural women of 40-50 years old(29.18%).The prevalence for urban women increased with aging.2.Analysis of influencing factors revealed,women in country,being overweight or obese,childbirth,parity≥2,history of deliver in macrosomia,assisted delivery,chronic constipation,chronic cough and hypertension,were risk factors for POP.3.Stratified analysis revealed,there were different risks of developing POP between urban and rural women who were had a history of delivery or macrosomia-delivering.Rural women were at a higher risk of POP than urban women.Women of parity=1 in different delivery modes were at significant different risk of developing POP.