Risk Factors for Uterovaginal Prolapse among Women in Public Hospitals of Sidama, Ethiopia: A Case Control Study

Hirut Yosef¹Tsegaye Alemu^2,3,4*Mekdes Wondirad Mengesha^3,4Aklilu Adule⁴

• ¹Yanet-Liyana College of Health Sciences, Addis Ababa, Addis Ababa, Ethiopia
• ²Hawassa University, Awasa, Ethiopia
• ³Department of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Southern Nations, Nationalities, and Peoples' Region, Ethiopia
• ⁴College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia

Introduction: Utero-vaginal prolapse is a significant public health concern in developing countries such as Ethiopia, where access to health care is limited. Despite this, there is limited evidence on risk factors in the study area. Therefore, this study aimed to identify the risk of utero-vaginal prolapse among women visiting gynecologic outpatient departments in governmental hospitals. Methods: A facility-based unmatched case‒control study was conducted among 286 women visiting gynecologic outpatient departments in selected governmental hospitals. The data were collected via a pretested structured questionnaire designed with a Kobo tool box. The Kobo tool is an easy, open electronic data collection tool suitable for field research and helps ensure data security. The data were subsequently exported to SPSS for analysis. Descriptive statistics were performed. To assess associations, independent t tests and binary and multivariate logistic regression analyses were performed. Finally, a 95% confidence interval and adjusted odds ratio with a p value <0.05 were used to examine the associations between the dependent and independent variables. Results: A total of 277 respondents, 91 patients with utero-vaginal prolapse and 186 controls, were included in the study. According to the multivariable logistic regression analysis, early childbirth [AOR=3.98 (95% CI: 1.08–14.58)], a history of multiple pregnancies [AOR=2.88 (95% CI: 1.27– 6.49)], home delivery [AOR=4.9 (95% CI: 1.3–18.6)], prior pelvic surgery [AOR=3.9 (95% CI: 1.08– 13.8)], and a history of instrumental delivery [AOR=3.1 (95% CI: 1.08–9.14)] were found to be significant determinants of utero vaginal prolapse. Conclusion: These findings underscore that in utero vaginal prolapse is a common reproductive health problem. Early childbirth, a history of multiple pregnancies, home delivery, prior pelvic surgery, and a history of instrumental delivery were risk factors for UVP. Therefore, social and health care system determinants are critical. Therefore, prevention of UVP requires promoting health facility deliveries, integrating obstetric care, and addressing the societal norms that may lead to early childbirth. Consequently, context-based interventions addressing these determinants can greatly improve women's quality of life, decrease the prevalence of UVP, and improve overall maternal health.