Female genital prolapse and risk of psychiatric disorders: A two-sample Mendelian randomization analysis

There is a growing body of evidence suggests a strong link between female genital prolapse (FGP) and mental health. However, the causal relationship between FGP and psychological disorders remains unclear.

Bidirectional Mendelian Randomization (MR) analysis has been applied to investigate the potential impact of FGP on the risk of seven common psychiatric disorders.

The two-sample MR analysis was conducted using genetic instruments such as Inverse variance weighted (IVW), MR Egger, weighted median, simple mode, and weighted mode from the genome-wide association study (GWAS) summary data in European populations. In addition, the Cochrane's Q test, MR-Egger intercept test, MR pleiotropy residual sum and outliers (MR-PRESSO) test and leave-one-out analysis were employed to assess the sensitivity and heterogeneity.

The MR results revealed that FGP exhibited a potential marginal protective effect on bipolar disorder (BD) (odds ratio(OR) = 0.92, 95%confidence interval (95%CI: 0.85-0.99, P = 0.03) as well as schizophrenia(OR = 0.91, 95%CI:0.85-0.98, P = 0.01). Nevertheless, there was no causal correlation between genetically predicted FGP and obsessive compulsive disorder (OCD) (OR = 0.98, 95%CI:0.80-1.20, P = 0.84),depression (broad) (OR = 1.00, 95%CI:0.99-1.01, P = 0.76), major depression(OR = 0.98, 95%CI:0.94-1.03, P = 0.43), anxiety disorders (OR = 1.00, 95%CI:0.94-1.07,P = 0.97) and post-traumatic stress disorder(PTSD) (OR = 1.18, 95%CI:0.88-1.57,P = 0.27),respectively. In addition, BD was found to have a potential significant influence on FGP in the inverse MR analysis (OR = 0.83, 95%CI:0.72-0.97, P = 0.02). No significant heterogeneity or horizontal pleiotropy detected, and the results were deemed stable based on sensitivity analysis and leave-one-out test .

There are shortcomings such as data limitations, population bias, potential pleiotropy, and stratified analysis.

While there is potential causal relationship between FGP and BD or schizophrenia, it does not exhibit any correction with OCD, depression (broad), major depression, anxiety disorders and PTSD among European populations.