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Vaginal Delivery Found to Increase Likelihood of Pelvic Organ Prolapse


 

SAVANNAH, GA. — Vaginal delivery—but not cesarean section delivery—appears to confer increased risk of stage 2 pelvic organ prolapse, based on the results of a study of almost 300 women.

“Vaginal parity—and not parity alone—was found to be a risk factor for prolapse severity,” wrote Dr. Lieschen Quiroz, of the obstetrics and gynecology department at Johns Hopkins Bayview Medical Center in Baltimore, and her colleagues regarding their study, which was presented as a poster at the annual meeting of the Society of Gynecologic Surgeons, jointly sponsored by the American College of Surgeons.

Each vaginal delivery was associated with a 35% increase in the risk of stage 2 or greater pelvic organ prolapse, while C-sections were not.

The researchers included all women seeking outpatient gynecologic and urogynecologic care at five locations in Baltimore.

Women were excluded if they either were pregnant or were not sexually active. Demographic data and childbirth history were collected.

The women also underwent Pelvic Organ Prolapse Quantitative (POP-Q) examination.

POP-Q data and childbirth history were available for 299 women.

Mean parity increased with increasing prolapse stage—from 1.4 for stage 0 to 3.1 for stage 3.

Age was also statistically associated with increasing prolapse stage.

Race, body mass index, and hysterectomy status were not associated with increasing prolapse stage.

For each vaginal birth, the relative odds ratio for having stage 2–4 prolapse was 1.35; for each C-section birth, the relative odds ratio for having stage 2–4 prolapse was 0.9. The findings suggest that delivery method may be a modifiable risk.

Dr. Quiroz stated that she had no relevant financial relationships to disclose.

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