{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T07:11:48Z","timestamp":1788505908166,"version":"build-2803163510"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that increases the risk of emphysema and chronic obstructive pulmonary disease (COPD). Increased intra-abdominal pressure associated with chronic cough and damage to connective tissues that support pelvic organs suggest an association between COPD and pelvic organ prolapse (POP), a condition with estimated population prevalence of 3\u20136%. This study examined the prevalence of symptomatic POP among women with AATD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Women \u226518 years with AATD were invited to participate in a survey in 2025. The Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6) assessed POP. Data were linked to previous survey responses including age, AATD genotype, the Chronic Airways Assessment Test (CAAT), body mass index, smoking, employment, lung disease, alpha-1 antitrypsin augmentation prescribed, and sleep apnea. Dichotomized POPDI-6 scores (&gt;17 versus \u226417) were assessed by participant characteristics using chi-squared tests, Fisher\u2019s exact tests, Wilcoxon\u2013Mann\u2013Whitney tests, and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of those invited to participate, 921 (36.1%) individuals completed the survey. POPDI-6 scores (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 917) were right-skewed, and 22.1% reported significant symptom distress (POPDI-6 &gt; 17). There were significant differences in dichotomized POPDI-6 scores by age, sleep apnea, hysterectomy, surgery, number of vaginal births, and AATD genotype. Women with POPDI-6 &gt;17 had higher overall and cough CAAT scores than those \u226417. No significant differences emerged for other characteristics. In adjusted logistic regression, there were increased odds of POPDI-6 &gt;17 with three or more vaginal births, a diagnosis of sleep apnea, increasing CAAT score, and a genotype of MZ, but decreased odds of POPDI-6 &gt;17 with increasing age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The prevalence of POP among women with AATD was higher than that estimated in the general population. Further studies are warranted to confirm this observation. Screening of women with AATD for POP may be an opportunity to identify needs for pelvic floor therapy and education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996261478679","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:30:47Z","timestamp":1786599047000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pelvic Organ Prolapse and Alpha-1 Antitrypsin Deficiency"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5243-8464","authenticated-orcid":false,"given":"Erika","family":"Fuchs","sequence":"first","affiliation":[{"name":"Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6891-3795","authenticated-orcid":false,"given":"Jennifer","family":"Cera","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA."},{"name":"Olson Center for Women\u2019s Health, Nebraska Medicine, Omaha, Nebraska, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen E.","family":"Holm","sequence":"additional","affiliation":[{"name":"Department of Medicine, National Jewish Health, Denver, Colorado, USA."},{"name":"AlphaNet Inc, Coral Gables, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8109-8067","authenticated-orcid":false,"given":"Charlie","family":"Strange","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Sandhaus","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Pediatrics, National Jewish Health, Denver, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isuzu","family":"Meyer","sequence":"additional","affiliation":[{"name":"Olson Center for Women\u2019s Health, Nebraska Medicine, Omaha, Nebraska, USA."},{"name":"Department of Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra J.","family":"Hergenrader","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Kruse","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Immad","family":"Munawar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeongjin","family":"Gwon","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen I.","family":"Rennard","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.105410"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmcr.2014.12.002"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-21-1064"},{"key":"e_1_3_2_5_1","first-page":"747","volume-title":"Fishman\u2019s Pulmonary Diseases and Disorders","author":"Rennard S","year":"2007","unstructured":"4.Rennard S, , Hepp L, , Daughton DM. Cigarette smoking and disease. In: Fishman\u2019s Pulmonary Diseases and Disorders. (Elias JA, , Fishman AP, , Grippi MA, , Senior RM, , Peck AI., eds). 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