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Racial Differences in Pelvic Organ Prolapse
Open accessAbstract
OBJECTIVE: To compare the estimated prevalence of, risk factors for, and level of bother associated with subjectively reported and objectively measured pelvic organ prolapse in a racially diverse cohort. METHODS: The Reproductive Risks for Incontinence Study at Kaiser 2 is a population-based cohort study of 2,270 middle-aged and older women. Symptomatic prolapse was self-reported, and bother was assessed on a five-point scale. In 1,137 women, prolapse was measured with the Pelvic Organ Prolapse Quantification (POP-Q) system. Multivariable logistic regression analysis was used to identify the independent association of prolapse and race while controlling for risk factors. RESULTS: The participants' mean (standard deviation) age was 55 (9) years, and 44% were white, 20% were African American, 18% were Asian American, and 18% were Latina or other race. Seventy-four women (3%) reported symptomatic prolapse. In multivariable analysis, the risk of symptomatic prolapse was higher in white (prevalence ratio 5.35, 95% confidence interval [CI] 1.89-15.12) and Latina (prevalence ratio 4.89, 95% CI 1.64-14.58) compared with African-American women. Race was not associated with report of moderate to severe bother. Degree of prolapse by POP-Q stage was similar across all racial groups; however, the risk of the leading edge of prolapse at or beyond the hymen was higher in white (prevalence ratio 1.40, 95% CI 1.02-1.92) compared with African-American women. CONCLUSION: Compared with African-American women, Latina and white women had four to five times higher risk of symptomatic prolapse, and white women had 1.4-fold higher risk of objective prolapse with leading edge of prolapse at or beyond the hymen. LEVEL OF EVIDENCE: II.
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“Compared with nulliparity, vaginal delivery was a significant risk factor in 2 studies 24,29 and could therefore be identified as a confirmed risk factor.”
From Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis (2022) · cites this paper as [29]
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“Of the 2 studies that could be pooled, the OR showed a borderline significant but small effect for Black ethnicity to be protective against primary POP (n¼2, pooled OR, 0.96; 95% CI, 0.92e1.00)”
From Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis (2022) · cites this paper as [29]
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“prior epidemiologic studies have described differences in symptomatic and objective prolapse by race and ethnicity.15,16”
From Characteristics Associated With Surgical Failure After Native Tissue Apical Prolapse Repair (2024) · cites this paper as [15]
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“For ethnicity, 1 study showed Black ethnicity to be protective against POP, 36 and 3 studies showed no association.”
From Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis (2022) · cites this paper as [29]
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Metadata
- Authors
- Whitcomb, E. L., Rortveit, G., Brown, J. S., Creasman, J. M., Thom, D. H., Van Den Eeden, S. K., & Subak, L. L.
- Affiliations
- Kaiser Permanente (US)
- ORCID
- Thom, David H.
- Venue
- Obstetrics & Gynecology
- Published
- 2009-12
- Volume
- 114
- Issue
- 6
- Pages
- 1271-1277
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC2879888
- OpenAlex
- W2049056259
- Semantic Scholar
- 77bd2e345315067c8ed5956b427c75f1008ed0e4
- Cited by
- 166
- References
- 25
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 29 · 2023: 15 · 2022: 13 · 2021: 19 · 2020: 11 · 2019: 8 · 2018: 11 · 2017: 9 · 2016: 7 · 2015: 8 · 2014: 6 · 2013: 4 · 2012: 5
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (P50DK064538, R01DK053335, DK53335, K24DK080775)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD 41134, R01HD041134)
- Topics
- Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- pelvic organ prolapse, racial disparities, African American women, Hispanic women, white women, risk factors, symptom bother, POP-Q staging, middle-aged and older women
- MeSH terms
- California, Female, Humans, Longitudinal Studies, Middle Aged, Risk Factors, Prevalence, Racial Groups, Pelvic Organ Prolapse
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