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Medline ® Abstract for Reference 56

of 'Urinary incontinence and pelvic organ prolapse associated with pregnancy and childbirth'

56
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Risk factors associated with pelvic floor disorders in women undergoing surgical repair.
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Moalli PA, Jones Ivy S, Meyn LA, Zyczynski HM
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Obstet Gynecol. 2003;101(5 Pt 1):869.
 
OBJECTIVE: To identify demographic, obstetric, and gynecologic risk factors associated with the development of pelvic floor disorders in women who undergo surgical correction.
METHODS: We conducted a case-control study, with cases selected from all women who had surgery by our urogynecology service from July 1, 1999 to July 1, 2000 and who had a first obstetric delivery at Magee Womens Hospital (n = 80). Controls were patients seen in the general gynecology office over the same time period who had no complaints associated with pelvic floor disorders in the previous 3 years, less than stage I prolapse on pelvic examination, and first obstetric delivery at Magee Womens Hospital (n = 176). Demographic, obstetric, and gynecologic variables were compared between cases and controls.
RESULTS: There were no significant differences in race, current age, gravidity, or parity. Cases were more likely than controls to have a higher body mass index (BMI) (28.6 +/- 6.3 versus 26.4 +/- 6.1 kg/m(2), P =.01), to be younger at first delivery (25.8 +/- 5.3 versus 28.4 +/- 4.9 years, P<.001), to have undergone a forceps delivery (64% versus 44%, P<orr =.001), and to have had previous gynecologic surgery (34% versus 16%, P =.003). Using logistic regression modeling, all of these factors were found to be independently associated with pelvic floor disorders. After menopause, use of hormone replacement therapy 5 or more years was protective (P =.001).
CONCLUSION: In our surgical patients, younger age at first delivery, higher BMI, forceps delivery, and history of gynecologic surgery were significantly associated with subsequent development of pelvic floor disorders.
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Department of Obstetrics, Gynecology, and Research, Magee Womens Hospital, Magee Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. rsipam@mail.magee.edu
PMID