Reproductive Risk Factors for Pelvic Organ Prolapse

描述(申请人提供)：盆腔器官脱垂是一种常见的疾病 中老年妇女的问题及其发展的危险因素 盆腔器官脱垂的定义不是很清楚。虽然分娩一直是 被确认为盆腔器官脱垂的危险因素的研究有限 特定分娩事件与母婴关系的研究 晚年发生盆腔器官脱垂。 目前，我们正在进行泌尿生殖危险因素的研究。 Kaiser的大小便失禁研究(RRISK)，一项为期4年的资助研究，以确定 特定分娩事件、子宫切除、激素使用与 随后的尿失禁。这项回溯性队列研究将纳入 2100名年龄在40岁至69岁之间的社区居住的不同种族的妇女 从18岁起就有连续的医疗记录。所有参与者都有 广泛评估尿失禁和潜在的危险因素 自我报告、面谈和分娩摘要图表 还有手术记录。 我们建议随机选择RRISK队列中1100名参与者的子样本 应用盆腔器官脱垂客观评价盆腔器官脱垂 量化分期系统。我们在未来4年的具体目标是 按阴道节段和严重程度确定脱垂的患病率(阶段I- 四)、年龄组别。研究对象的伦理多样性将使 主要族裔群体之间患病率估计数的比较；确定 分娩的特定方面与儿童发育之间的联系 晚年脱垂；确定子宫切除术与 (类型和适应症)和随后的脱垂；识别其他潜在的 风险因素(举重、肥胖、医疗疾病等)对于脱垂， 尤其是那些可预防或可修改的；并描述 盆腔器官脱垂与尿便失禁和 以比较每种情况下的风险因素。 我们建议对井中脱垂的生殖风险因素进行研究- 具有代表性的社区居住妇女队列将提供 足够的样本量，出色的结果衡量标准，以及广泛的可靠性 关于盆腔器官脱垂的一系列危险因素的数据，包括图表 摘要介绍了生育史的重要方面。 确定脱垂的风险因素将有助于指导 用于检验修正危险因素效果的预防性干预试验 盆腔器官脱垂。

DESCRIPTION (provided by applicant): Pelvic organ prolapse is a common problem among middle-aged and older women and risk factors for the development of pelvic organ prolapse are not well defined. While childbirth has been identified as a risk factor for pelvic organ prolapse, there has been limited research on the relationship between specific parturition events and the occurrence of pelvic organ prolapse in later life. Currently, we are conducting the Reproductive Risk factors for urinary Incontinence Study at Kaiser (RRISK), a 4-year funded study to determine the association between specific childbirth events, hysterectomy, hormone use and subsequent urinary incontinence. This retrospective cohort study will enroll 2100 community-dwelling, ethnically diverse women ages 40 to 69 on which there are continuous medical records since the age of 18. All participants had extensive assessment of urinary incontinence and potential risk factors using self-report, in-person interview, and chart abstraction of labor and delivery and surgical records. We propose randomiy selecting a 1100 participant subsample of the RRISK cohort to objectively assess pelvic organ prolapse using the Pelvic Organ Prolapse Quantitation staging system. Our specific aims over the next 4 years are to detennine the prevalence of prolapse by vaginal segment and severity (Stage I- IV), and age group. The ethmc diversity of study subjects will allow comparison of prevalence estimates between major ethnic groups; to determine the association between specific aspects of parturition and development of prolapse in later life; to ascertain the association between hysterectomy (type and indication) and subsequent prolapse; To identify other potential risk factors (heavy lifting, obesity, medical illness, etc.) for prolapse, especially those that are preventable or modifiable; and to describe the associations of pelvic organ prolapse with urinary and fecal incontinence and to compare risk factors for each of these conditions. Our proposed study of reproductive risk factors for prolapse in a well- characterized representative cohort of community-dwelling women will provide an adequate sample size, excellent outcome measures, and extensive reliable data on a range of risk factors for pelvic organ prolapse, including chart abstracted information on important aspects of reproductive history. Identification of risk factors for prolapse will help guide the development of preventive intervention trials to test the efficacy of modifying risk factors for pelvic organ prolapse.