History of cervical insufficiency increases the risk of pelvic organ prolapse and stress urinary incontinence in parous women
| Autor: | David Hackney, Konyinsola Dawodu, Sherif A. El-Nashar, Kateena L. Addae-Konaedu, Alison M. Bauer, David Sheyn |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Stress incontinence Cervical insufficiency Adolescent Urinary Incontinence Stress medicine.medical_treatment Urinary incontinence Pelvic Floor Disorders Pelvic Organ Prolapse General Biochemistry Genetics and Molecular Biology Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Cervical cerclage 030212 general & internal medicine Young adult Aged Aged 80 and over Gynecology 030219 obstetrics & reproductive medicine Pelvic floor business.industry Confounding Obstetrics and Gynecology Middle Aged medicine.disease Logistic Models medicine.anatomical_structure Gestation Female Uterine Cervical Incompetence medicine.symptom business |
| Zdroj: | Maturitas. 107:63-67 |
| ISSN: | 0378-5122 |
| DOI: | 10.1016/j.maturitas.2017.10.009 |
| Popis: | Objective A likely contributor to pelvic floor disorders is injury and degradation of connective tissue components such as collagen and elastin, leading to weakening of the pelvic floor. Prior studies have found similar connective tissue component changes in women with cervical insufficiency (CI). However, the connection between pelvic floor disorders and cervical insufficiency has not previously been evaluated. Our objective was to determine whether a history of cervical insufficiency is associated with an increased risk of pelvic organ prolapse and stress urinary incontinence after controlling for confounders. Study design The study used de-identified clinical data from a large multi-institution electronic health records HIPAA-compliant data web application, Explorys Inc. (Cleveland, Ohio, USA). Women with a history of at least one prior delivery after at least 20 weeks’ gestation between the years 1999 and 2016 were identified. Logistic regression models were used to identify risk factors and adjust for confounders. Main outcome measures The primary outcome was subsequent development of either stress incontinence or pelvic organ prolapse. Results A total of 1,182,650 women were identified, of whom 30,890 (2.6%) had a history of cervical cerclage or insufficiency. A history of cervical insufficiency was associated with an increased risk of either pelvic organ prolapse or stress urinary incontinence (aOR = 1.93, 95%CI: 1.84–2.02). A history of cervical insufficiency was more strongly associated with an increased risk of pelvic organ prolapse (aOR = 2.06, 95%CI: 1.91–2.21) than with stress urinary incontinence (aOR = 1.91, 95%CI: 1.80–2.02). Conclusion A history of cervical insufficiency is associated with an increased risk of development of pelvic organ prolapse and stress urinary incontinence. |
| Databáze: | OpenAIRE |
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