Assessing the link between birth interval and pelvic organ prolapse severity in reproductive-age women in rural Turkey: A cross-sectional study on quality of life.

Abstract

Objective: Pelvic organ prolapse (POP) impacts women's quality of life globally. We aimed to assess the association between the number of births, minimum birth intervals, and POP grade, and their relationship with quality of life in reproductive-aged women in rural Turkey.

Methods: This cross-sectional study was conducted in rural Turkey from June to September 2024, involving women attending a rural state hospital's gynecology clinic. Participants were divided into group 1 (n = 96, POP stage 0-1) and group 2 (n = 96, POP stage 2-3-4), using Pelvic Organ Prolapse Quantification (POP-Q) system staging. Genital hiatus and perineal body measurements were recorded, and the Prolapse Quality of Life (P-QOL) questionnaire was administered. As outcome measures, we assessed the number of births, minimum birth intervals, genital hiatus, perineal body measurements, and sociodemographic factors, for their associations with POP-Q stage and quality of life.

Results: Participants' mean age was 38.0 ± 7.4 years. Women in group 2 had more vaginal deliveries (4.4 ± 1.5 vs. 4.0 ± 1.5; P = 0.042), shorter minimum birth intervals (18.5 ± 7.9 vs. 25 ± 29.5 months; P = 0.004), higher birth weight of the heaviest child (3667.5 ± 540.6 vs. 3468.1 ± 523.3 g; P = 0.008), and larger genital hiatus (4.3 ± 0.9 vs. 3.5 ± 1.0 cm; P < 0.001). Group 2 had significantly higher P-QOL scores, indicating poorer quality of life. Receiver operating characteristic (ROC) curve analysis identified predictive thresholds for severe prolapse: six or more vaginal deliveries, genital hiatus diameter ≥5.25 cm, and heaviest child's birth weight ≥4250 g.

Conclusion: Increased number of vaginal births, higher birth weight of the heaviest baby, and shorter intervals between births are significantly associated with more severe POP stages.