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Obstet Gynecol. 2009 Dec;114(6):1271-7. doi: 10.1097/AOG.0b013e3181bf9cc8.

Racial differences in pelvic organ prolapse.

Author information

  • 1Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Reproductive Medicine, University of California, San Diego, California, USA. ewhitcomb@ucsd.edu

Abstract

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.

PMID:
19935029
[PubMed - indexed for MEDLINE]
PMCID:
PMC2879888
Free PMC Article
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