Cesarean section and risk of pelvic organ prolapse: a nested case-control study.

ABSTRACT

OBJECTIVE: The objective of the study was to investigate the association between cesarean section and pelvic organ prolapse. STUDY DESIGN: The Swedish Hospital Discharge Registry was used to identify women with an inpatient diagnosis of pelvic organ prolapse, and the data were linked to the Swedish Medical Birth Registry. Odds ratios (ORs) were estimated using the Mantel-Haenzsel procedure and Cox analyses to estimate hazard ratios. The material was stratified for age and parity. RESULTS: A total of 1.4 million women were investigated. A strong and statistically significant association between cesarean section and pelvic organ prolapse was found. Adjusted OR was 0.18 (0.16-0.20) and overall hazard ratio 0.20 (0.18-0.22). CONCLUSION: Cesarean section is associated with a lower risk of pelvic organ prolapse than vaginal delivery.