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How do reproductive history and anthropometry in midlife relate to later risk of pelvic organ prolapse? A prospective cohort study

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Abstract

Introduction and hypothesis

The objective was to examine the association between reproductive and anthropometric factors and later risk of pelvic organ prolapse (POP).

Methods

We carried out a prospective cohort study including 11,114 female nurses > 44 years from the Danish Nurse Cohort. In 1993, the study population was recruited through the Danish Nurse Organization and self-reported data on age, height, weight, age at menarche, age at first birth and number of childbirths were obtained. POP diagnosis was obtained from the National Patient Registry. Risk of POP was estimated using COX regression and presented as hazard ratios (HR) with 95% confidence intervals (CI).

Results

Overall, 10% of the women received a diagnosis of POP within a median follow-up of 22 years. A 4% increase in risk of POP was seen for each increasing BMI (kg/m2) unit at baseline. Compared to women of normal weight, higher risks of POP were seen in overweight (HR 1.18: 1.02–1.36) and obese women (HR 1.33: 1.02–1.74), while underweight had a lower risk (HR 0.51: 0.27–0.95). Compared to women with one childbirth, women with no childbirths had a reduced risk of 57% while increased risks of 46%, 78% and 137% were observed in women with two, three and four childbirths. Women with menarche before the age of 12 tended to have a higher risk of POP as did women who were 30–33 years at their first childbirth.

Conclusions

POP is a common health problem in women, and BMI and number of childbirths are strong predictors.

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Acknowledgements

The authors thank all the nurses who participated in The Danish Nurse Cohort.

Author information

Authors and Affiliations

  1. Occupational and Environmental Medicine, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark

    Anne-Line Brülle

  2. Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000, Odense C, Denmark

    Chunsen Wu, Vibeke Rasch & Ellen Aagaard Nohr

  3. Department of Gynaecology and Obstetrics, Odense University Hospital, Kløvervænget 23, 5000, Odense C, Denmark

    Chunsen Wu, Vibeke Rasch & Ellen Aagaard Nohr

  4. Department of Neurology and Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark

    Mette Kildevæld Simonsen

  5. Department of Gynaecology and Obstetrics, Sørlandet Sykehus HF, Kristiansand, Norway

    Ine Schmidt Schøyen

  6. Department of Paediatrics, Sørlandet Sykehus HF, Kristiansand, Norway

    Carina Dahl

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  1. Anne-Line Brülle
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Corresponding author

Correspondence to Anne-Line Brülle.

Ethics declarations

The data were received and analysed fully as anonymized data and therefore exempt from ethical approval. The Danish Nurse Cohort was approved by the Scientific and Ethical Committee of Copenhagen and Frederiksberg Municipalities [J.nr. (KF) 01–103/93] and by the Danish Data Protection Agency (BFH-2018-001 and I-Suite nr.: 06102).

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Brülle, AL., Wu, C., Rasch, V. et al. How do reproductive history and anthropometry in midlife relate to later risk of pelvic organ prolapse? A prospective cohort study. Int Urogynecol J 33, 3373–3380 (2022). https://doi.org/10.1007/s00192-022-05122-8

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  • DOI: https://doi.org/10.1007/s00192-022-05122-8

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