Association Between Joint Hypermobility and Pelvic Organ Prolapse: A Hospital‐Based Cross‐Sectional Study
Zekra Ali AzizABSTRACT
Background and Aims
Pelvic organ prolapse (POP) is a prevalent disorder of the pelvic floor with multifactorial etiology. Generalized joint hypermobility (JHM) is a sign of systemic collagen laxity. This study investigated the association between generalized JHM and POP and examined other clinical correlates including parity, body mass index (BMI), heavy occupational lifting, and family history in Middle Eastern females.
Methods
This hospital‐based cross‐sectional study evaluated 812 non‐pregnant women aged ≥ 20 years attending an outpatient gynecology clinic at Erbil Maternity Teaching Hospital between November 2021 and April 2024. POP was staged using the standardized Pelvic Organ Prolapse Quantification (POP‐Q) system. Generalized JHM was defined as a Beighton score ≥ 4/9. Multivariable logistic regression and correlation analyses assessed independent correlates and severity trends.
Results
Among 812 participants, 444 had POP (54.7%) and 368 served as non‐POP controls (45.3%). JHM was present in 67.6% (300/444) of POP cases versus 10.9% (40/368) of controls (unadjusted OR 17.08, 95% CI: 11.64–25.07; p < 0.001). In multivariable logistic regression, JHM remained strongly associated with POP (adjusted OR [aOR] 28.11, 95% CI: 17.21–45.91; p < 0.001). Family history of POP (aOR 9.69, 95% CI: 5.58–16.83; p < 0.001), heavy lifting (aOR 6.48, 95% CI: 4.05–10.37; p < 0.001), and parity (per birth aOR 1.17, 95% CI: 1.08–1.27; p < 0.001) were also independently associated with POP. Beighton scores increased significantly across advancing POP‐Q severity stages (Kruskal–Wallis p < 0.001; Spearman's ρ = 0.30, p < 0.001).
Conclusion
Generalized joint hypermobility is strongly and independently associated with pelvic organ prolapse, with Beighton scores showing a positive correlation across prolapse severity stages. While joint hypermobility screening represents a simple clinical examination tool, prospective longitudinal studies are needed to determine whether such screening can improve risk stratification or guide preventive pelvic floor care.