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Indicators were pooled with random or fixed effect meta\u2010analysis based on heterogeneity\u00a0and sub\u2010grouped analysed by the biopsy site.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Thirty cross\u2010sectional studies were included, comprising 840 POP cases and 755 controls. Overall results showed that the expression of type III collagen (COLIII) and several matrix metalloproteinases (MMP\u20101, \u20102 and \u20109) were increased, whereas those of type I collagen (COLI), and tissue inhibitor of matrix metalloproteinase\u20101 (TIMP\u20101) were decreased in patients with POP. Subgroup analysis showed that the expression of COLIII in the anterior vaginal wall (AVW) and COLIII, MMP\u20102 and \u20109 in the uterosacral ligament (USL) were consistent with the overall results. However, the expression of COLI and MMP\u20101 in the AVW showed no difference and the expression of COLI and MMP\u20101 in the USL is still controversial based on current studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with POP have lower expression of COLI and TIMP\u20101 and higher expression of COLIII and MMPs compared with non\u2010POP cases, but further studies are required to investigate in specified anatomical sites.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17768","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T08:20:23Z","timestamp":1706689223000},"page":"1029-1041","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["The difference in extracellular matrix metabolism in women with and without pelvic organ prolapse: A systematic review and 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