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01-01-2022 | Estrogens | Review Article

Age and/or postmenopausal status as risk factors for pelvic organ prolapse development: systematic review with meta-analysis

Authors: Luiz Gustavo Oliveira Brito, Glaucia Miranda Varella Pereira, Pamela Moalli, Oksana Shynlova, Jittima Manonai, Adi Yehuda Weintraub, Jan Deprest, Maria Augusta T. Bortolini

Published in: International Urogynecology Journal | Issue 1/2022

Abstract

Introduction and hypothesis

Age is named as a risk factor for pelvic organ prolapse (POP), despite not being the primary outcome for many observational studies. Postmenopausal status is another associated factor but has many confounders. We aimed to systematically review the role of age and/or postmenopausal status in POP development.

Methods

Systematic review addressing age and hormones, more specifically by postmenopausal status, from inception to March 2020 in four databases (PubMed, Embase, WOS, Cochrane Library). Quality of evidence was classified by the ROBINS-I classification for non-randomized studies. Experimental studies, animal studies, studies linking age with recurrent POP and case series were excluded. Effect estimates were collected from adjusted odds ratio plus 95% confidence intervals. Significance level was 5%. A discussion exploring mechanistic factors was also included.

Results

Nineteen studies (11 cross sectional, 6 cohort and 2 case control) were included for quantitative analysis. Only two studies presented a low overall risk of bias for age; most of the domains were of moderate risk. Every additional year was responsible for a 10% increase in the risk to develop POP (OR = 1.102 [1.021–1.190]; i² = 80%, random analysis, p = 0.012). This trend was confirmed when age was dichotomized into a cutoff of 35 (p = 0.035) and 50 (p < 0.001) years. Although an increase in the risk for POP was noted in postmenopausal women, this did not reach statistical significance (OR = 2.080 [0.927–4.668], i² = 0%, p = 0.076).

Conclusion

Age is a risk factor for POP; postmenopausal status was not statistically associated with POP, prompting the need for further studies addressing this factor.

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Title: Age and/or postmenopausal status as risk factors for pelvic organ prolapse development: systematic review with meta-analysis
Authors: Luiz Gustavo Oliveira Brito
Glaucia Miranda Varella Pereira
Pamela Moalli
Oksana Shynlova
Jittima Manonai
Adi Yehuda Weintraub
Jan Deprest
Maria Augusta T. Bortolini
Publication date: 01-01-2022
Publisher: Springer International Publishing
Keyword: Estrogens
Published in: International Urogynecology Journal / Issue 1/2022
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-021-04953-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Age and/or postmenopausal status as risk factors for pelvic organ prolapse development: systematic review with meta-analysis

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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