International Urogynecology Journal

, Volume 24, Issue 3, pp 413–418 | Cite as

The familiality of pelvic organ prolapse in the Utah Population Database

  • Peggy A. Norton
  • Kristina Allen-Brady
  • Lisa A. Cannon-Albright
Original Article

Abstract

Introduction and hypothesis

Pelvic organ prolapse (POP) in women is a common condition whose etiology is poorly understood. There is increasing evidence that POP is heritable. The aim of our study was to define and evaluate familial clustering of POP.

Methods

Using a population-based Utah genealogy linked to more than a decade of hospital data, we calculated relative risks (RR) of POP in female relatives of women with POP using age- and birth year-specific rates of POP. We compared the average pairwise relatedness of all POP cases to the population using a measure of genetic distance.

Results

We identified 1,292 women with diagnostic and procedure codes for POP. The RR of POP was significantly elevated in first- and third-degree female relatives (RR 4.15, p < 0.001; RR 1.24, p = 0.05). The average pairwise relatedness for all individuals with POP was significantly higher than expected (p < 0.001).

Conclusions

These results strongly support a significant heritable contribution to POP.

Keywords

Familiality Pelvic organ prolapse Family history Genetics Population database Genital prolapse 

Notes

Conflicts of interest

Supported by grants from the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development R01 HD41163 (PAN) and RO1 HD061821 (LCA and PAN).

References

  1. 1.
    Swift S (2000) The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol 183(2):277–285PubMedCrossRefGoogle Scholar
  2. 2.
    Subak L, Waetjen L, van den Eeden S, Thom D, Vittinghoff E, Brown J (2001) Cost of pelvic organ prolapse surgery in the United States. Obstet Gynecol 98:646–651PubMedCrossRefGoogle Scholar
  3. 3.
    Jelovsek J, Maher C, Barber M (2007) Pelvic organ prolapse. Lancet 369:1027–1038PubMedCrossRefGoogle Scholar
  4. 4.
    Rortveit G, Daltveit AK, Hannestad Y, Hunskaar S, Norwegian EPINCONT Study (2003) Urinary incontinence after vaginal delivery or cesarean section. N Engl J Med 348(10):900–907PubMedCrossRefGoogle Scholar
  5. 5.
    Patel DA, Xu X, Thomason AD, Ransom SB, Ivy JS, DeLancey JO (2006) Childbirth and pelvic floor dysfunction: an epidemiologic approach to the assessment of prevention opportunities at delivery. Am J Obstet Gynecol 195(1):23–28PubMedCrossRefGoogle Scholar
  6. 6.
    Buchsbaum GM, Duecy EE, Kerr LA, Huang LS, Guzick DS (2005) Urinary incontinence in nulliparous women and their parous sisters. Obstet Gynecol 106(6):1253–1258PubMedCrossRefGoogle Scholar
  7. 7.
    Mushkat Y, Bukovsky I, Langer R (1996) Female urinary stress incontinence–does it have familial prevalence? Am J Obstet Gynecol 174(2):617–619PubMedCrossRefGoogle Scholar
  8. 8.
    Jack GS, Nikolova G, Vilain E, Raz S, Rodríguez LV (2006) Familial transmission of genitovaginal prolapse. Int Urogynecol J Pelvic Floor Dysfunct 17(5):498–501PubMedCrossRefGoogle Scholar
  9. 9.
    Nikolova G, Lee H, Berkovitz S, Nelson S, Sinsheimer J, Vilain E, Rodríguez LV (2007) Sequence variant in the laminin gamma1 (LAMC1) gene associated with familial pelvic organ prolapse. Hum Genet 120(6):847–856PubMedCrossRefGoogle Scholar
  10. 10.
    Allen-Brady K, Norton P, Farnham J, Teerlink C, Cannon-Albright L (2009) Significant linkage evidence for a predisposition gene for pelvic floor disorders on chromosome 9q21. Am J Hum Genet 84(5):678–682PubMedCrossRefGoogle Scholar
  11. 11.
    Allen-Brady K, Camp NJ, Ward JH, Cannon-Albright LA (2005) Lobular breast cancer: excess familiality observed in the Utah Population Database. Int J Cancer 117(4):655–661PubMedCrossRefGoogle Scholar
  12. 12.
    Hammoud AO, Gibson M, Peterson CM, Kerber RA, Mineau GP, Hatasaka H (2008) Quantification of the familial contribution to müllerian anomalies. Obstet Gynecol 111:378–384PubMedCrossRefGoogle Scholar
  13. 13.
    Cannon-Albright LA, Thomas A, Goldgar DE, Gholami K, Rowe K, Jacobsen M, McWhorter WP, Skolnick MH (1994) Familiality of cancer in Utah. Cancer Res 54:2378–2385PubMedGoogle Scholar
  14. 14.
    Cannon-Albright LA, Skolnick MH, Bishop DT, Lee RG, Burt RW (1988) Common inheritance of susceptibility to colonic adenomatous polyps and associated colorectal cancers. N Engl J Med 319(9):533–537PubMedCrossRefGoogle Scholar
  15. 15.
    Horne BD, Camp NJ, Muhlestein JB, Cannon-Albright LA (2004) Evidence for a heritable component in death resulting from aortic and mitral valve diseases. Circulation 110(19):3143–3148PubMedCrossRefGoogle Scholar
  16. 16.
    Agresti A (2001) Exact inference for categorical data: recent advances and continuing controversies. Stat Med 20(17–18):2709–2722PubMedCrossRefGoogle Scholar
  17. 17.
    Jorde LB (1989) Inbreeding in the Utah Mormons: an evaluation of estimates based on pedigrees, isonomy, and migration matrices. Ann Hum Genet 53(4):339–355PubMedCrossRefGoogle Scholar
  18. 18.
    Stefansson T, Moller P, Sigurdsson F, Steingrimsson E, Eldon B (2006) Familial risk of colon and rectal cancer in Iceland: evidence for different etiologic factors? Int J Cancer 119:304–308PubMedCrossRefGoogle Scholar
  19. 19.
    McLellan T, Jorde LB, Skolnick MH (1984) Genetic distances between the Utah Mormons and related populations. Am J Hum Genet 36(4):836–857PubMedGoogle Scholar
  20. 20.
    Weber A, Richter H (2005) Pelvic organ prolapse. Obstet Gynecol 106(3):615–634PubMedCrossRefGoogle Scholar
  21. 21.
    Miki Y, Swensen J, Shattuck-Eidens D, Futreal PA, Harshman K, Tavtigian S et al (1994) A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science 266:66–71PubMedCrossRefGoogle Scholar
  22. 22.
    Easton DF, Steele L, Fields P, Ormiston W, Averill D, Daly PA et al (1997) Cancer risks in two large breast cancer families linked to BRCA2 on chromosome 13q12-13. Am J Hum Genet 61:120–128PubMedCrossRefGoogle Scholar
  23. 23.
    Grodin J, Thliveris A, Samowitz W, Carlson M, Gelbert L, Albertsen H et al (1991) Identification and characterization of the familial adenomatous polyposis coli gene. Cell 66:589–600CrossRefGoogle Scholar
  24. 24.
    Ross O, Farrer M (2005) Pathophysiology, pleiotropy and paradigm shifts: genetic lessons from Parkinson’s disease. Biochem Soc Trans 33(4):586–590PubMedCrossRefGoogle Scholar
  25. 25.
    Wechsler M, Israel E (2002) The genetics of asthma. Semin Respir Crit Care Med 23(4):331–338PubMedCrossRefGoogle Scholar
  26. 26.
    Kalantar J, Locke G, Zinsmeister A, Beighley C, Talley N (2003) Familial aggregation of irritable bowel syndrome: a prospective study. Gut 52(12):1703–1707PubMedCrossRefGoogle Scholar
  27. 27.
    Bischoff F, Simpson J (2004) Genetic basis of endometriosis. Ann N Y Acad Sci 1034:284–299PubMedCrossRefGoogle Scholar
  28. 28.
    Kerber RA, Neklason DW, Samowitz WS, Burt RW (2005) Frequency of familial colon cancer and hereditary nonpolyposis colorectal cancer (Lynch syndrome) in a large population database. Fam Cancer 4(3):239–244PubMedCrossRefGoogle Scholar
  29. 29.
    Jorde LB (2001) Consanguinity and prereproductive mortality in the Utah Mormon population. Hum Hered 52:61–65PubMedCrossRefGoogle Scholar
  30. 30.
    DeLancey JO (2005) The hidden epidemic of pelvic floor dysfunction: achievable goals for improved prevention and treatment. Am J Obstet Gynecol 192(5):1488–1495PubMedCrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2012

Authors and Affiliations

  • Peggy A. Norton
    • 1
    • 4
  • Kristina Allen-Brady
    • 2
  • Lisa A. Cannon-Albright
    • 2
    • 3
  1. 1.Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic SurgeryUniversity of Utah Health Sciences CenterSalt Lake CityUSA
  2. 2.Department of Medicine, Division of Genetic EpidemiologyUniversity of Utah Health Sciences CenterSalt Lake CityUSA
  3. 3.George E. Wahlen Department of Veterans Affairs Medical CenterSalt Lake CityUSA
  4. 4.Department of Obstetrics and GynecologyUniversity of Utah School of MedicineSalt Lake CityUSA

Personalised recommendations