Determinants of Pelvic Organ Prolapse in Women of Nagar, Gilgit-Baltistan: A Case–Control Study

Abstract Background Pelvic organ prolapse (POP) is a common but under-investigated gynecological condition, particularly in low-resource and mountainous regions. This study aimed to identify sociodemographic and reproductive risk factors associated with POP among women in Nagar District, Gilgit-Baltistan, Pakistan. Methods A case-control study was conducted in 2016 among women aged 18–65 presenting to a primary health facility in Nagar. Forty women with clinically confirmed POP (grade 3 or 4) were individually matched with 38 controls based on age, ethnicity, and village. Data were collected between March and September 2016 through structured interviews and clinical examinations using the Baden-Walker grading system. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using bivariate analysis, followed by multivariate logistic regression to identify independent risk factors. Results Women with POP were significantly more likely to have illiterate husbands (OR 4.51, 95% CI: 1.7–11.93, p = 0.002), belong to lower socioeconomic strata (OR 0.14, 95% CI: 0.046–0.44, p < 0.001), and report heavy physical workload (p < 0.001). Home delivery (OR 3.08, 95% CI: 1.09–8.79, p = 0.03), lack of postpartum rest (< 30 days) (OR 45.0, 95% CI: 10.95–184.79, p < 0.001), chronic cough (OR 6.95, 95% CI: 2.07–23.29, p = 0.001), urinary tract infection (OR 4.64, 95% CI: 0.91–23.52, p = 0.047), and constipation (OR 2.8, 95% CI: 1.08–7.25, p = 0.032) were also significantly associated with POP. Multivariate analysis identified inadequate postpartum rest (aOR 38.2, 95% CI: 8.1–180.4, p < 0.001), husband's illiteracy (aOR 3.8, 95% CI: 1.2–12.1, p = 0.024), and chronic cough (aOR 5.2, 95% CI: 1.3–20.8, p = 0.019) as independent risk factors. Conclusion POP among women in Nagar is associated with a constellation of modifiable risk factors, particularly those related to socioeconomic disadvantage, high physical burden, and lack of maternal care. Interventions tailored to the local context—such as community education, postpartum care programs, and healthcare system strengthening—are urgently needed.