The Matrix Metalloproteinase-9 Gene Polymorphisms as Risk Factor for Pelvic Organ Prolapse in Balinese Women

Abstract

Aim: Pelvic organ prolapse (POP), although not life-threatening, is a serious condition that can affect a patient’s quality of life. As life expectancy rises, the number of women with POP continues to rise. The weakness of the pelvic floor is always found underlying each case of POP. This weakness in the pelvic floor is associated with repeated damage to muscles and connective tissue due to the process during pregnancy and delivery. Balinese women have risk factors for developing POP related to the obligation to continue their offspring by conceiving and giving birth more than 4 times and working as heavy workers. The presence of genetic factors is also thought to play a role as a risk factor for POP in Balinese women. The purpose of this study was to prove the existence of polymorphism matrix metalloproteinase-9 (MMP-9) rs17576 as a factor that puts Balinese women at risk for POP. Materials and methods: A paired case–control study was conducted on each of 30 Balinese women with POP and without prolapse, which was done matching based on parity and occupation variables at Sanglah Hospital, Denpasar and Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University. The EDTA tube contains 3 milliliters of venous blood, from which the sample material is taken. DNA isolationPCR, and sequencing examinations were performed to determine the presence of MMP-9 rs17576 gene polymorphism. Results: Balinese women’s POP risk was quadrupled by the gene polymorphism of the MMP-9 rs17576 genotype AG compared to without prolapse (OR = 4.00, 95% CI 1.13–14.18, p = 0.04). Conclusion: In Balinese women, the presence of MMP-9 rs17576 gene polymorphism raises the risk of POP.