Determinants of Utero-vaginal prolapse in Western Ethiopia

Determinants of Utero-vaginal prolapse in Western Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Determinants of Utero-vaginal prolapse in Western Ethiopia Gamachis Firdisa, Temesgen Tilahun, Gemechu Kejela This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-27815/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Background: Uterovaginal prolapse is a significant public health concern in developing countries like Ethiopia where access to health care is limited. It significantly affects women’s health and productivity. Thus, it is very important to identify determinant factors and take preventive actions. Methods: A hospital-based unmatched case-control study was conducted on 86 cases and 258 controls who attended gynecologic outpatient departments in Nekemte town, from May 1 to July 30/2019. Cases were women with grade II, III & IV uterovaginal prolapse while controls were women free from uterovaginal prolapse but with other gynecologic diseases. Data were collected using pretested interviewer-administered structured questionnaires and measurements on height and weight were taken to calculate the body mass index of women. Data were entered using Epi Data version 3.1 and analysis was carried out by SPSS version 24.0. Descriptive, bivariate, and multivariable logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used and statistical significance was declared at p<0.05. Results: This study revealed, age ≥40 years (AOR=10.49; 95%CI: 4.03, 27.35), duration of labor ≥24 hours (AOR=8.32; 95%CI: 3.58, 19.33), instrumental delivery (AOR=7.40; 95%CI: 1.21, 45.28), non- utilization of family planning (AOR=3.14; 95%CI: 1.32, 7.47) and underweight (BMI <18.5 kg/m 2 ) 5.30 (AOR=5.30; 95%CI: 1.83, 15.33) were determinants of utero vaginal prolapse. Conclusion: A ge ≥ 40 years, prolonged labor, instrumental delivery, non-utilization of family planning, and underweight were identified as determinant factors of uterovaginal prolapse. Thus, family planning service utilization and appropriate and timely obstetric care are advisable. Preventive Medicine Internal Medicine Case-control Determinants Utero-vaginal prolapse women Figures Figure 1 Background Utero vaginal prolapse (UVP) is the descent of the uterus through the vaginal canal due to defects in the support structures of the uterus and vagina because of different factors. It is manifested by protruding mass per vagina, urinary, and rectal complaints [1,2]. Utero vaginal prolapse is a common pelvic floor disorder among women of reproductive age and postmenopausal women. It occurs both in developed and developing countries with an overall global prevalence of 2-20%. For instance, it is 3.4% in Nigeria, 20.4% in the united kingdom, 14% in the united states of America, and 27.1% in Turkey [3-6]. In Ethiopia, gynecological problems are important health problems affecting maternal health outcomes and women’s productivity. In Ethiopia study done in Jimma and St. Paul’s millennium medical college hospitals have revealed that Pelvic Organ Prolapse (POP) accounted for 40.7% and 15% of all gynecologic surgeries respectively [7, 8]. Though pelvic organ prolapse is not a life-threatening condition, it has significant effects on socioeconomic status, woman psychology, health, sexual function, and overall quality of life [9-12]. A review of the literature around the world revealed different factors for the development of uterovaginal prolapse. The most important once are factors that increase intra-abdominal pressure, difficult labor and delivery, malnutrition, old age, connective tissue disorders, heavy exercise, and pelvic trauma [7, 13-29]. But what factors lead to the occurrence of UVP are not well studied in Ethiopia. There are only a few studies in the country that relied on patient records which might be subjected to information bias due to incompleteness and poor quality of secondary data (7, 8). Also, to the best of the authors' knowledge, there was no study on determinants of utero-vaginal prolapse in Western Ethiopia. Thus, the current study assessed the determinant factors of UVP in Western Ethiopia using primary data. Methods Study Area and Period A hospital-based unmatched case-control study was conducted among women attending gynecologic Out Patient Department (OPD) in Nekemte town, from May 1 to July 30/2019. Nekemte town, the capital city of East Wollega zone is found at 331 km west of Addis Ababa. According to the 2018 Nekemte town health Office report, the total population of Nekemte town was 127,380 of which 51.03%, 49.97%, 16.4%, and 3.47% comprised of male, female, under-five children and pregnant women respectively. The dominant ethnic group is Oromo. There are two public hospitals in the town namely Nekemte specialized hospital and Wollega University referral hospital. These hospitals give services including Obstetric and gynecologic services to nearly 5 million people in western Ethiopia and adjacent areas. They have well-organized gynecology and obstetrics departments which are led by 7 gynecologists and 15 general practitioners. These two hospitals provide uterovaginal prolapse and other surgical interventions. Source Population All women attending gynecologic OPD at public hospitals in Nekemte town were the source population. Study population All women attending gynecologic OPD at public hospitals in Nekemte town during the study period. Cases were women with grade II, III & IV uterovaginal prolapse. Controls were those women free from uterovaginal prolapse but with some other gynecologic disease during the same study period. All women aged more than 18 years attending OPD during the study period were included in the study. However, women with grade I UVP, women with a total abdominal hysterectomy and vaginal hysterectomy, critically ill women, and women with mental problems were excluded from the study. Sample Size Determination and sampling procedure The sample size was calculated using Epi-info software version 7 using sample size determination for unmatched case-control studies. The parameters that were used to calculate sample size were; Confidence level 95%, power 80%, control to case ratio of 3: 1, the proportion of controls with exposure 6.2%, the proportion of cases with exposure 18.5%, and Odd Ratio of 3.1. It was calculated from the study conducted in Bahir Dar town, North West Ethiopia by taking BMI (< 18.5 kg/m 2 ) as one of the main exposure variables for pelvic organ prolapse that provide the maximum sample size [13]. Therefore, it yields 78 cases and 232 controls. Adding a 10% non-response rate, the final sample size becomes 341 (86 cases and 258 controls). Two hospitals in Nekemte town were included because they were providing surgical intervention for cases of UVP. Then based on the number of clients who visited the gynecologic OPD of these two hospitals during the previous three months (60 cases and 358 controls for Wollega University Referral hospital, and 45 cases and 308 controls for Nekemte specialized hospital), the sample size was proportionally allocated to each hospital. Finally, cases in the two hospitals were included consecutively and three controls for each case were selected using a systematic sampling method. Measurements Uterovaginal prolapse is defined as the descent of either of the uterus, cervix, vagina or associated structures such as bladder and rectum(1). Inter-pregnancy interval was defined as the interval between the most recent previous childbirth and the starting time of pregnancy for the current child as reported by the mother at the time of the interview. In this study, the women faced labor-intensive work if she reported frequent engagement to works like lifting and carrying heavy objects. Chronic cough is defined as a cough that lasts two months or more. Chronic constipation is defined as a stool frequency of less than three per week that lasts several months or having difficulty passing stools. In this study, abortion is defined as either spontaneous or induced termination of pregnancy before fetal viability (before 28 weeks of gestational age according to Ethiopian context). Data Collection Tools and Procedures Data on socio-demographic, obstetric, gynecologic, and medical history were collected by using a pre-tested structured interviewer-administered questionnaire which was developed by reviewing different literatures [13, 27, 30, 31,32]. Four BSc nurses and two MSc supervisors were recruited and trained for data collection. All questionnaires were checked for completeness daily by the supervisors. Physical measurement was used to obtain data on the weight and height of women. In this regard, the weight of each woman was measured using a balanced beam in kg nearest to 0.1kg and height was measured using a measuring tape to the nearest 0.1cm. To diagnose uterovaginal prolapse, gynecologists working in Out Patient Department were used. Pelvic examination was done after a woman had emptied her bladder. The examination was done in a lithotomy position. To avoid intra-rater and inter-rater reliability, the authors had a thorough discussion with attending gynecologists on finding documentation. Shaw’s classification system of uterovaginal prolapse was used for grading of the disease. In this classification system, the descent is classified into four grades; the first grade is the descent of the cervix into the vagina, second grade is the descent of the cervix into the introitus, third grade is the descent of the cervix outside the introitus, and the fourth grade is when the whole of the uterus is outside introitus [1]. Data Quality Assurance The questionnaire was first prepared in English and then translated to the local language (Afan Oromo). The data collectors and supervisors were trained for two days on data collection and details of the study. A pretest was conducted on 4 cases and 12 controls at Mettu Karl Hospital which is located in southwest Ethiopia. Data Processing and Analysis After checking for completeness, data were entered using Epi Data version 3.1. It was then cleaned and exported to SPSS Version 20 for analysis. Frequency distribution and percentage were used to describe predictor variables. Also, descriptive statistics including mean and standard deviation were conducted to describe continuous variables. Bivariate analysis was used to examine the association between dependent and independent variables; Odds Ratios (ORs) and their 95% Confidence Intervals (CIs) were calculated. All variables that had a P-value of < 0.2 in the bivariate analysis were included in the multivariate logistic regression analysis model to identify determinant factors of uterovaginal prolapse. Statistical significance was set at a p-value of < 0.05. In the model development process, the existence of multi-collinearity was assessed to rule out the interaction among independent variables using the variance inflation factor (VIF). Accordingly, the result of VIF was close to one which showed minimal collinearity. The model was assessed for the goodness of fit using the Hosmer-Lemeshow test. Since the p-value for the Hosmer-Lemeshow chi-square was greater than 0.05(P=0.965), the model estimate was adequate to fit the data at an acceptable level. Result Socio-Demographic Characteristics of study participants Out of the total sample size, 325 respondents (82 cases and 243 controls) participated in the interview with the response rate of 95.3%. The mean age of study participants was 34.9 years with mean and SD of ±10.5 (45.9(±10.4 SD) years for cases and 31.2(±7.6 SD) years for controls. The proportion of older age women (age ≥ 40) was found to be higher among cases (65.9%) compared to controls (8.6%) (p=0.001). The majority of study participants, both in cases and controls, were Oromo by ethnicity, protestant in religion, and married. Forty seven (57.3%) of cases and 122(50.2%) of controls had no formal education (p=0.01). More than half of participants among cases 47(57.3%) and controls 140(57.6%) were housewives (p=0.022). From a total of women involved, 54(65.9%) of cases and, 135(55.6%) of controls were rural residents (Table 1) . Obstetrics Characteristics of study participants From the total study participants, 57(70.4%) of cases and, 180(75.6%) of controls were married at the age of eighteen and above (p=0.043). Greater than three-fourths of cases 66(81.5%) and nearly half 108(47.6%) of controls had pregnancy experience great or equal to four (p=0.001). Forty nine ( 62.8%) of cases and 111(56.6%) of controls had an average inter-pregnancy interval of ≤2 years. Fifty one (63%) of cases and 62(27.3%) of controls had no ANC follow up for the last pregnancy (p=0.001). The larger proportion of cases 58(71.6%) and controls 151(66.5%) did labor-intensive work during the last pregnancy (p=0.001). Sixty (74.1%) of cases and 78(35.6%) of controls had ≥4 total number of delivery (0.001). Forty-two (51.9%) of cases and 34(15.5%) controls gave birth at home (0.001). The majority of cases (80.2%) and (86.8%) of controls gave birth vaginally to the last baby (p=0.022). The proportion of women who experienced vaginal tear during the last delivery were 7(8.6%) among cases and 14(6.4%) among controls (p=0.002) (Table2) . Fifty-four (66.7%) of cases and fifty-five (25.1%) of controls stayed in labor for great or equal to 24 hours during the last childbirth. However, 28 (33.30%) of cases and 188 (74.90%) of controls stayed in labor for less than 24 hours during the last childbirth (p=0.016). Medical Problems among study participants From study participants, 17(20.7%) of cases and 16(6.6%) of controls had a history of chronic cough (p=0.001). Thirty-six (43.9%) of cases and 40(16.5%) of controls had a history of carrying heavy objects (p=0.001). Among women involved in the study, 47(14.5%), 3(0.9%), 63(19.4%), 5(1.5%), 6(1.8%) had hypertension, diabetes mellitus and chronic constipation respectively (p=0.003, p=0.201, p=0.001). Regarding participants’ BMI, 50(61.0%) of cases and 183(75.3%) of controls had BMI of 18.5-24.9 kg/m 2 (p=0.001) (Table 3) . Determinants of uterovaginal prolapse among study participants The odds of developing UVP concerning different characteristics of women were estimated by odds ratio using binary logistic regression analysis. Variables having a p-value of less than 0.2 at bivariate analysis were taken to multivariable analysis. In the final model, the odds of having UVP across each independent variable were adjusted for confounding effects. Accordingly, age, duration of labor, mode of delivery, family planning use, family history of UVP, and low BMI were predictor variables that remained significantly associated with UVP at p-value less than 0.05. Multivariable logistic regression analysis indicated that women aged > 40 years had 10.5 times greater odds of experiencing uterovaginal prolapse compared to those aged <40 years (AOR=10.49; 95%CI: 4.03, 27.35). Women who had a duration of labor greater or equal to 24 hours during the last childbirth had 8.32 times higher odds of developing UVP compared to those who stayed less than 24 hours (AOR=8.32; 95%CI: 3.58, 19.33). Women who gave birth by instrumental delivery had 7.40 times higher odds of developing UVP compared to women who gave birth by cesarian section (AOR=7.40; 95%CI: 1.21, 45.28). Women who did not ever use family planning had 3.14 times higher odds of developing UVP compared to their counterparts (AOR=3.14; 95%CI: 1.32, 7.47). Similarly, women with a family history of UVP had 3.77 times higher odds of developing UVP compared to their counterparts (AOR=3.77; 95%CI: 1.10. 12.88). Also, underweight women had 5.3 times higher odds of developing UVP compared to women with normal weight (AOR=5.30; 95%CI: 1.83, 15.33). However, the effect of residence, gravidity, parity, place of delivery, menopausal status, history of chronic cough, chronic constipation, and carrying heavy objects were no longer significant after adjusting for confounders (Table 4) . Discussion The main objective of the study was to identify the determinant factors of UVP among women attending gynecologic OPD at public hospitals in Western Ethiopia. Accordingly, many modifiable factors were identified to affect the occurrence of UVP. Different studies reported that the risk of UVP increases with age [7,13,15,26,28]. This study also revealed that women aged ≥40 years had 10.49 times higher odds of experiencing UVP compared to women aged <40 years. This might be due to age-related weakening of pelvic supportive structures, decreased level of estrogen, and high parity in this age group. However, a study conducted in Gondar Dabat district, Ethiopia, reported a contradictory finding [33]. The duration of labor great or equal to 24 hours was significantly associated with the development of uterovaginal prolapse. This finding is consistent with previous reports from India [25], Nepal [30], Tanzania[35], Nigeria [19], and Ethiopia [7]. This could be because prolonged labor causes more damage to supportive structures of the uterus and other pelvic organs. Prolonged labor can also be complicated by obstructed labor which might need aggressive interventions like operative deliveries that might worsen damage to already weakened structures. Previous studies indicated a controversial association between instrumental deliveries and pelvic prolapse. A study in Greater Baltimore Medical Center in Towson has suggested that operative delivery(forceps or vacuum) substantially increases the odds for pelvic organ prolapse[36] while a population-based study in Sweden [37] failed to show this association. Interestingly, this study identified a significant association between instrumental delivery and UVP. Women who delivered either by forceps or vacuum had 7.4 times higher odds of developing UVP compared to women who delivered by cesarian section. A possible explanation could be due to stretching and tearing as a result of excessive traction applied during difficult instrumental deliveries[31]. Women who did not use family planning had 3.14 times higher odds of developing UVP compared to their counterparts. This finding is similar to the study conducted at Wolaita Sodo University Referral Hospital [32]. This is because mothers who do not use family planning have repeated deliveries during which cumulative effects of pushing down pain might damage the pelvic support structures. However, a study conducted in England [3] did not show an association between the utilization of family planning and the development of UVP. In this study, family history was found to be a predictor for UVP. Women with a family history of UVP had 3.77 times higher odds of developing UVP compared to their counterparts. This is consistent with studies conducted in Addis Ababa, Ethiopia [8], and Nepal [33]. Similarly, a study conducted in Italy reported that the risk of urogenital prolapse was higher in women with a family history of prolapse as compared to women without a family history of prolapse [17]. This could be due to the presence of congenital connective tissue disorders in these families. Like a report from Bahir Dar, Ethiopia [13], underweight (BMI <18.5 kg/m 2 ) was also found to be a determinant of UVP in this study. This is due to the possibility of micronutrient deficiencies which are necessary for connective tissue strength. On the other hand, other studies showed that obesity (BMI ≥25 kg/m 2 ) is a risk factor for UVP [15, 23,30]. Limitations of this study include; small sample size that might lead to statistical imprecision; since participants were asked about some of their previous health-related events, it is subjected to recall bias; cases and controls were not matched by age, which might be an important contributor to the occurrence of UVP; and the possibility of errors in measuring exposure variables of interest which might impact the internal validity of the study. CONCLUSIONS: Age ≥ 40 years, prolonged labor, instrumental delivery, non-utilization of family planning, family history of UVP, and underweight were identified as determinant factors of uterovaginal prolapse. Therefore, creating awareness for women regarding possible risk factors and preventive measures of uterovaginal prolapse, training for health professionals on how to manage prolonged labor and how to use instrumental delivery cautiously, and further study that utilize strong designs are recommended. Declarations Ethical Considerations Ethical clearance was obtained from Wollega University Institute of Health Sciences Ethical Review Board. Additionally, a letter of cooperation was written to respective hospitals by Wollega University Institute of Health Sciences. To obtain permission, hospital administrations were informed before starting data collection. All participants were given adequate information regarding the purpose, risk and benefit, and confidentiality of the study as described in the information sheet. Participation was fully voluntary and written informed consent was taken from each participant. Confidentiality of patient was kept and the information was merely used for this study. Acknowledgments The authors would like to thank Wollega University Institute of Health Sciences for funding this study. Especial thanks also go to all supervisors, data collectors, and study participants for their cooperation and support during the study. Authors’ contributions GF, TT, and GK were involved in all components of this research, including conception, design, and supervision of data collection, data analysis and write up of the manuscript. All authors read and approved the final manuscript. Funding There was no funding source. Availability of data and materials The data sets used and analyzed for the current study are available from the corresponding author on reasonable request. Consent for publication Not applicable. Competing interest The authors declare that they have no competing interests. Authors detail 1 Department of Nursing, College of Medicine and Health Sciences, Mettu University, Mettu, Ethiopia. 2 School of Medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia. 3 Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia. References Howkins and Bourne, Shaw’s Textbook of Gynaecology. 17th edition. Elsevier India;2018. Anthony R.B. Smith. 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Prevalence and Factors Affecting Women with Uterine Prolapse in Lekhnath , Kaski , Nepal. J Gandaki Med Coll. 2016;09(2):52–71. Berihun MZ, Adefris M, Rortveit G, et al. Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study. Int Urogynecol J. 2013;24(7):1135–1143. Masenga GG, Shayo BC, Rasch V. Prevalence and risk factors for pelvic organ prolapse in Kilimanjaro, Tanzania: A population based study in Tanzanian rural community,2018. PLoS ONE 13(4): e0195910. https://doi.org/10.1371/ journal.pone.0195910 Handa VL, Blomquist JL, Knoepp LR, Hoskey KA, McDermott KC, Muñoz A. Pelvic floor disorders 5-10 years after vaginal or cesarean childbirth. Obstet Gynecol . 2011;118(4):777-784. doi:10.1097/AOG.0b013e3182267f2f Tegerstedt G, Miedel A, Maehle-Schmidt M, Nyrén O, Hammarström M. Obstetric risk factors for symptomatic prolapse: a population-based approach. Am J Obstet Gynecol. 2006 Jan; 194(1):75-81. Tables Table 1: Socio demographic characteristics of women attending gynecologic OPD among cases and controls at public hospitals in Nekemte town, Western Ethiopia, 2019 Characteristics of Respondents Cases Number (%) Controls Number (%) P-Value Age ≥ 40 <40 54(65.9) 28(34.1) 21(8.6) 222(91.4) 0.001 Ethnicity Oromo Amhara Other(Tigre, Guraghe) 74(90.2) 7(8.5) 1(1.2) 225(92.6) 13(5.3) 5(2.1) 0.527 Religion Protestant Orthodox Muslim Other(Catholic, Adventist) 50(61.0) 25(30.5) 6(7.3) 1(1.2) 150(61.7) 55(22.6) 35(14.4) 3(1.2) 0.253 Education of Women No education Primary(1-8 grade) Secondary(9-12 grade) College and above 47(57.3) 25(30.5) 7(8.5) 3(3.7) 122(50.2) 76(31.3) 35(14.4) 10(4.1) 0.010 Occupation House wife Merchant Government employee Daily laborer Farmer 47(57.3) 10(12.2) 2(2.4) 3(3.7) 20(24.4) 140(57.6) 35(14.4) 11((4.5) 4((1.6) 53(21.8) 0.022 Marital Status Single( single, divorced, widowed) Married 3(3.7) 79(96.3) 8(3.3) 235(96.7) 0.081 Residence Urban Rural 28(34.1) 54(65.9) 108(44.4) 135(55.6) 0.102 Table 2: Obstetrics and gynecologic history of women attending gynecologic OPD among cases and controls at public hospitals in Nekemte town, Western Ethiopia, 2019 Characteristics Cases Number (%) Controls Number (%) P-Value Age at first marriage ≥18 years <18 years 57(70.4) 24(29.6) 180(75.6) 58(24.4) 0.043 Age at first pregnancy <20 years ≥20 years 36(44.4) 45(55.6) 112(49.3) 115(50.7) 0.370 Gravidity ≥4 2 years 49(62.8) 29(37.2) 111(56.6) 85(43.4) 0.348 History of abortion Yes No 41(50.6) 40(49.4) 105(46.3) 122(53.7) 0.500 ANC follow up Yes No 30(37.0) 51(63.0) 165(72.7) 62(27.3) 0.001 Labor intensive work Yes No 58(71.6) 23(28.4) 151(66.5) 76(33.5) 0.001 Ever gave child birth Yes No 81(100.0) 0(0.0) 219(96.5) 8(3.5) 0.087 Parity ≥4 <4 60(74.1) 21(25.9) 78(35.6) 141(64.4) 0.001 Number of vaginal deliveries ≥4 <4 59(72.8) 22(27.2) 69(32.2) 145(67.8) 0.001 Place of delivery (for the last child) Home Health facility 42(51.9) 39(48.1) 34(15.5) 185(84.5) 0.001 Mode of delivery (for the last child) Spontaneous vaginal delivery Instrumental delivery Cesarean section 65(80.2) 11(13.6) 5(6.2) 190(86.8) 10(4.6) 19(8.7) 0.022 Vaginal tear (during last child birth) Yes No 7(8.6) 74(91.4) 14(6.4) 205(93.6) 0.002 Sphincter damage (during the last child birth) Yes No 2(2.5) 79(97.5) 2(0.9) 217(99.1) 0.007 Episiotomy (during the last child birth) Yes No 5(6.2) 76(93.8) 18(8.2) 201(91.8) 0.017 Duration of rest after delivery (for the last child) ≤42 days >42 days 59(72.8) 22(27.2) 168(76.7) 51(23.3 0.016 Ever used family planning Yes No 16(19.5) 66(80.5) 129(53.1) 114(46.9) 0.001 Menopausal status Premenopausal Postmenopausal 33(40.5) 49(59.5) 222(91.4) 21(8.6) 0.001 Family history of UVP Yes No 17(20.7) 65(79.3) 13(5.3) 230(94.7) 0.001 Table 3: Medical problems and history of pelvic surgery among cases and controls at public hospitals in Nekemte town, Western Ethiopia, 2019 Variables Cases Number (%) Controls Number (%) P-Value History of chronic cough Yes No 17(20.7) 65(79.3) 16(6.6) 227(93.4) 0.001 Hypertension Yes No 13(15.9) 69(84.1) 34(14.0) 209(86.0) 0.003 Diabetic mellitus Yes No 1(1.2) 81(98.8) 2(0.8) 241(99.2) 0.201 Chronic constipation Yes No 30(36.6) 52(63.4) 33(13.6) 210(86.4) 0.001 Ever smoke cigarette Yes No 3(3.7) 79(96.3) 4(1.6) 239(98.4) 0.278 Carry heavy objects Yes No 36(43.9) 46(56.1) 40(16.5) 203(83.5) 0.001 Previous prolapse surgery Yes No 4(4.9) 78(95.1) 2(0.8) 241(99.2) 0.018 BMI 18.5-24.9 kg/m 2 <18.5 kg/m 2 ≥25 kg/m 2 50(61.0) 27(32.9) 5(6.1) 183(75.3) 18(7.4) 42(17.3) 0.001 Table 4: Bivariate and multivariable logistic analysis of determinants of utero-vaginal prolapse among women attending gynecologic OPD at public hospitals in Nekemte town, Ethiopia, 2019 Variables Cases N (%) Controls N (%) Crude OR(95%CI) Adjusted OR(95%CI) Age ≥40 <40 54(65.9) 28(34.1) 21(8.6) 222(91.4) 20.39(10.76, 38.63) 1 10.49(4.03,27.35)* 1 Residence Urban Rural 28(34.1) 54(65.9) 108(44.4) 135(55.6) 1 1.54(0.92,2.60) 0.59(0.25,1.39) Gravidity ≥4 <4 66(81.5) 15(18.5) 108(47.6) 119(52.4) 4.85(2.61,8.99) 1 1.29(0.32,5.26) 1 Parity ≥4 <4 60(74.1) 21(25.9) 78(35.6) 141(64.4) 5.17(2.93,9.12) 1 2.12(0.88,5.04) 1 Place of delivery (for the last child) Home Health facility 42(51.9) 39(48.1) 34(15.5) 185(84.5) 5.86(3.31,10.35) 1 1.43(0.49,4.11) 1 Duration of labor (for the last child) ≥24 hours <24 hours 54(66.7) 27(33.3) 55(25.1) 164(74.9) 5.96(3.43,10.38) 1 8.32(3.58,19.33)* 1 Mode of delivery (for the last child) SVD Instrumental delivery Cesarean section 65(80.2) 11(13.6) 5(6.2) 190(86.8) 10(4.6) 19(8.7) 1.30(0.47,3.62) 4.18(1.13,15.42) 1 1.11(0.25,4.90) 7.40(1.21,45.28)* 1 Ever used family planning Yes No 16(19.5) 66(80.5) 129(53.1) 114(46.9) 1 4.67(2.56,8.52) 1 3.14(1.32,7.47)* Menopausal status Premenopausal Postmenopausal 33(40.5) 49(59.5) 222(91.4) 21(8.6) 1 15.69(8.29.43) 1 1.77(0.44,7.17) Family history of UVP Yes No 17(20.7) 65(79.3) 13(5.3) 230(94.7) 4.63(2.14,10.02) 1 3.77(1.10,12.88)* 1 History of chronic cough Yes No 17(20.7) 65(79.3) 16(6.6) 227(93.4) 3.71(1.78,7.75) 1 1.97(0.56,6.72) 1 Chronic constipation Yes No 30(36.6) 52(63.4) 33(13.6) 210(86.4) 3.67(2.06,6.56) 1 1.92(0.78,4.74) 1 Carry heavy objects Yes No 36(43.9) 46(56.1) 40(16.5) 203(83.5) 3.97(2.29,6.90) 1 1.94(0.82,4.60) 1 BMI 18.5-24.9 kg/m 2 <18.5 kg/m 2 ≥25 kg/m 2 50(61.0) 27(32.9) 5(6.1) 183(75.3) 18(7.4) 42(17.3) 1 5.49(2.80,10.77) 0.44(0.16,1.16) 1 5.30(1.83,15.33)* 0.40(0.10,1.51) Note: ⃰ represents statistical significance at p<0.05 Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-27815","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":1796814,"identity":"c2163c16-a468-46d4-ac06-8e180c577978","order_by":0,"name":"Gamachis Firdisa","email":"","orcid":"","institution":"Metu University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Gamachis","middleName":"","lastName":"Firdisa","suffix":""},{"id":1796815,"identity":"d8c37e18-023b-4637-8bd4-f3ffd337d31d","order_by":1,"name":"Temesgen Tilahun","email":"","orcid":"","institution":"Wollega University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Temesgen","middleName":"","lastName":"Tilahun","suffix":""},{"id":1796816,"identity":"68a29e6d-1e77-44ae-be1f-031e4c855b36","order_by":2,"name":"Gemechu Kejela","email":"data:image/png;base64,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","orcid":"","institution":"","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Gemechu","middleName":"","lastName":"Kejela","suffix":""}],"badges":[],"createdAt":"2020-05-08 08:30:03","currentVersionCode":2,"declarations":"","doi":"10.21203/rs.3.rs-27815/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-27815/v2","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":2170773,"identity":"8b1ac413-6942-4fc4-b00e-fd036f06a877","added_by":"auto","created_at":"2020-08-31 19:46:42","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":161385,"visible":true,"origin":"","legend":"Duration of labor during last childbirth among cases and controls at public hospitals in Nekemte town, Western Ethiopia, 2019","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-27815/v2/1.png"},{"id":13586754,"identity":"cfe824c0-fc06-47a7-a5d7-3200fcb30b1d","added_by":"auto","created_at":"2021-09-17 04:48:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":739760,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-27815/v2/2e3041e0-9cfe-424d-95ec-25f723788b6e.pdf"}],"financialInterests":"","formattedTitle":"Determinants of Utero-vaginal prolapse in Western Ethiopia","fulltext":[{"header":"Background","content":"\u003cp\u003eUtero vaginal prolapse (UVP) is the descent of the uterus through the vaginal canal due to defects in the support structures of the uterus and vagina because of different factors. It is manifested by protruding mass per vagina, urinary, and rectal complaints [1,2].\u003c/p\u003e\n\u003cp\u003eUtero vaginal prolapse is a common pelvic floor disorder among women of reproductive age and postmenopausal women. It occurs both in developed and developing countries with an overall global prevalence of 2-20%. For instance, it is 3.4% in Nigeria, 20.4% in the united kingdom, 14% in the united states of America, and 27.1% in Turkey [3-6].\u003c/p\u003e\n\u003cp\u003eIn Ethiopia, gynecological problems are important health problems affecting maternal health outcomes and women\u0026rsquo;s productivity. In Ethiopia study done in Jimma and St. Paul\u0026rsquo;s millennium medical college hospitals have revealed that Pelvic Organ Prolapse (POP) accounted for 40.7% and 15% of all gynecologic surgeries respectively [7, 8].\u003c/p\u003e\n\u003cp\u003eThough pelvic organ prolapse is not a life-threatening condition, it has significant effects on socioeconomic status, woman psychology, health, sexual function, and overall quality of life [9-12]. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA review of the literature around the world revealed different factors for the development of uterovaginal prolapse. The most important once are factors that increase intra-abdominal pressure, difficult labor and delivery, malnutrition, old age, connective tissue disorders, heavy exercise, and pelvic trauma [7, 13-29].\u003c/p\u003e\n\u003cp\u003eBut what factors lead to the occurrence of UVP are not well studied in Ethiopia. There are only a few studies in the country that relied on patient records which might be subjected to information bias due to incompleteness and poor quality of secondary data (7, 8). Also, to the best of the authors' knowledge, there was no study on determinants of utero-vaginal prolapse in Western Ethiopia. Thus, the current study assessed the determinant factors of UVP in Western Ethiopia using primary data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003ca name=\"_Toc24617539\"\u003e\u003c/a\u003e\u003cstrong\u003eStudy Area and Period\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA hospital-based unmatched case-control study was conducted among women attending gynecologic Out Patient Department (OPD) in Nekemte town, from May 1 to July 30/2019. Nekemte town, the capital city of East Wollega zone is found at 331 km west of Addis Ababa. According to the 2018 Nekemte town health Office report, the total population of Nekemte town was 127,380 of which 51.03%, 49.97%, 16.4%, and 3.47% comprised of male, female, under-five children and pregnant women respectively. The dominant ethnic group is Oromo. There are two public hospitals in the town namely Nekemte specialized hospital and Wollega University referral hospital. These hospitals give services including Obstetric and gynecologic services to nearly 5 million people in western Ethiopia and adjacent areas. They have well-organized gynecology and obstetrics departments which are led by 7 gynecologists and 15 general practitioners. These two hospitals provide uterovaginal prolapse and other surgical interventions.\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc24617541\"\u003e\u003c/a\u003e\u003cstrong\u003eSource Population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll women attending gynecologic OPD at public hospitals in Nekemte town were the source population.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll women attending gynecologic OPD at public hospitals in Nekemte town during the study period. Cases were women with grade II, III \u0026amp; IV uterovaginal prolapse. Controls were those women free from uterovaginal prolapse but with some other gynecologic disease during the same study period. All women aged more than 18 years attending OPD during the study period were included in the study. However, women with grade I UVP, women with a total abdominal hysterectomy and vaginal hysterectomy, critically ill women, and women with mental problems were excluded from the study.\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc24617547\"\u003e\u003c/a\u003e\u003cstrong\u003eSample Size Determination\u003c/strong\u003e\u003cstrong\u003e and sampling procedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sample size was calculated using Epi-info software version 7 using sample size determination for unmatched case-control studies. The parameters that were used to calculate sample size were; Confidence level 95%, power 80%, control to case ratio of 3: 1, the proportion of controls with exposure 6.2%, the proportion of cases with exposure 18.5%, and Odd Ratio of 3.1. It was calculated from the study conducted in Bahir Dar town, North West Ethiopia by taking BMI (\u0026lt; 18.5 kg/m\u003csup\u003e2\u003c/sup\u003e) as one of the main exposure variables for pelvic organ prolapse that provide the maximum sample size [13]. Therefore, it yields 78 cases and 232 controls. Adding a 10% non-response rate, the final sample size becomes 341 (86 cases and 258 controls).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTwo hospitals in Nekemte town were included because they were providing surgical intervention for cases of UVP. Then based on the number of clients who visited the gynecologic OPD of these two hospitals during the previous three months (60 cases and 358 controls for Wollega University Referral hospital, and 45 cases and 308 controls for Nekemte specialized hospital), the sample size was proportionally allocated to each hospital. Finally, cases in the two hospitals were included consecutively and three controls for each case were selected using a systematic sampling method.\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc24617549\"\u003e\u003c/a\u003e\u003cstrong\u003eMeasurements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUterovaginal prolapse is defined as the descent of either of the uterus, cervix, vagina or associated structures such as bladder and rectum(1). Inter-pregnancy interval was defined as the interval between the most recent previous childbirth and the starting time of pregnancy for the current child as reported by the mother at the time of the interview. In this study, the women faced labor-intensive work if she reported frequent engagement to works like lifting and carrying heavy objects. Chronic cough is defined as a cough that lasts two months or more. Chronic constipation is defined as a stool frequency of less than three per week that lasts several months or having difficulty passing stools. In this study, abortion is defined as either spontaneous or induced termination of pregnancy before fetal viability (before 28 weeks of gestational age according to Ethiopian context).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Data \u003c/strong\u003e\u003cstrong\u003eCollection Tools and Procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData on socio-demographic, obstetric, gynecologic, and medical history were collected by using a pre-tested structured interviewer-administered questionnaire which was developed by reviewing different literatures [13, 27, 30, 31,32]. Four BSc nurses and two MSc supervisors were recruited and trained for data collection. All questionnaires were checked for completeness daily by the supervisors.\u003c/p\u003e\n\u003cp\u003ePhysical measurement was used to obtain data on the weight and height of women. In this regard, the weight of each woman was measured using a balanced beam in kg nearest to 0.1kg and height was measured using a measuring tape to the nearest 0.1cm. To diagnose uterovaginal prolapse, gynecologists working in Out Patient Department were used. Pelvic examination was done after a woman had emptied her bladder. The examination was done in a lithotomy position. To avoid intra-rater and inter-rater reliability, the authors had a thorough discussion with attending gynecologists on finding documentation.\u003c/p\u003e\n\u003cp\u003eShaw\u0026rsquo;s classification system of uterovaginal prolapse was used for grading of the disease.\u0026nbsp; In this classification system, the descent is classified into four grades; the first grade is the descent of the cervix into the vagina, second grade is the descent of the cervix into the introitus, third grade is the descent of the cervix outside the introitus, and the fourth grade is when the whole of the uterus is outside introitus [1].\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc24617550\"\u003e\u003c/a\u003e\u003cstrong\u003eData Quality Assurance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe questionnaire was first prepared in English and then translated to the local language (Afan Oromo). The data collectors and supervisors were trained for two days on data collection and details of the study. A pretest was conducted on 4 cases and 12 controls at \u0026nbsp;Mettu Karl Hospital which is located in southwest Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc24617555\"\u003e\u003c/a\u003e\u003cstrong\u003e\u0026nbsp;Data Processing and Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc24617556\"\u003e\u003c/a\u003eAfter checking for completeness, data were entered using Epi Data version 3.1. It was then cleaned and exported to SPSS Version 20 for analysis. Frequency distribution and percentage were used to describe predictor variables. Also, descriptive statistics including mean and standard deviation were conducted to describe continuous variables. Bivariate analysis was used to examine the association between dependent and independent variables; Odds Ratios (ORs) and their 95% Confidence Intervals (CIs) were calculated. All variables that had a P-value of \u0026lt; 0.2 in the bivariate analysis were included in the multivariate logistic regression analysis model to identify determinant factors of uterovaginal prolapse. Statistical significance was set at a p-value of \u0026lt; 0.05. In the model development process, the existence of multi-collinearity was assessed to rule out the interaction among independent variables using the variance inflation factor (VIF). Accordingly, the result of VIF was close to one which showed minimal collinearity. The model was assessed for the goodness of fit using the Hosmer-Lemeshow test. Since the p-value for the Hosmer-Lemeshow chi-square was greater than 0.05(P=0.965), the model estimate was adequate to fit the data at an acceptable level.\u003c/p\u003e"},{"header":"Result","content":"\u003cp\u003e\u003cstrong\u003eSocio-Demographic Characteristics of study participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOut of the total sample size, 325 respondents (82 cases and 243 controls) participated in the interview with the response rate of 95.3%. The mean age of study participants was 34.9 years with mean and SD of \u0026plusmn;10.5 (45.9(\u0026plusmn;10.4 SD) years for cases and 31.2(\u0026plusmn;7.6 SD) years for controls. The proportion of older age women (age \u0026ge; 40) was found to be higher among cases (65.9%) compared to controls (8.6%) (p=0.001). \u0026nbsp;The majority of study participants, both in cases and controls, were Oromo by ethnicity, protestant in religion, and married.\u0026nbsp; \u0026nbsp;Forty seven (57.3%) of cases and 122(50.2%) of controls had no formal education (p=0.01). More than half of participants among cases 47(57.3%) and controls 140(57.6%) were housewives (p=0.022). From a total of women involved, 54(65.9%) of cases and, 135(55.6%) of controls were rural residents \u003cstrong\u003e(Table 1)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc24617560\"\u003e\u003c/a\u003e\u003cstrong\u003eObstetrics Characteristics of \u003c/strong\u003e\u003cstrong\u003estudy participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrom the total study participants, 57(70.4%) of cases and, 180(75.6%) of controls were married at the age of eighteen and above (p=0.043). Greater than three-fourths of cases 66(81.5%) and nearly half 108(47.6%) of controls had pregnancy experience great or equal to four (p=0.001). Forty nine \u003cstrong\u003e(\u003c/strong\u003e62.8%) of cases and 111(56.6%) of controls had an average inter-pregnancy interval of \u0026le;2 years. Fifty one (63%) of cases and 62(27.3%) of controls had no ANC follow up for the last pregnancy (p=0.001). The larger proportion of cases 58(71.6%) and controls 151(66.5%) did labor-intensive work during the last pregnancy (p=0.001). Sixty (74.1%) of cases and 78(35.6%) of controls had \u0026ge;4 total number of delivery (0.001). Forty-two (51.9%) of cases and 34(15.5%) controls gave birth at home (0.001). The majority of cases (80.2%) and (86.8%) of controls gave birth vaginally to the last baby (p=0.022). \u0026nbsp;The proportion of women who experienced vaginal tear during the last delivery were 7(8.6%) among cases and 14(6.4%) among controls (p=0.002)\u003cstrong\u003e (Table2)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Fifty-four (66.7%) of cases and fifty-five (25.1%) of controls stayed in labor for great or equal to 24 hours during the last childbirth. However, 28 (33.30%) of cases and 188 (74.90%) of controls stayed in labor for less than 24 hours during the last childbirth (p=0.016).\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc24617561\"\u003e\u003c/a\u003e\u003cstrong\u003eMedical Problems \u003c/strong\u003e\u003cstrong\u003eamong study participants \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrom study participants, 17(20.7%) of cases and 16(6.6%) of controls had a history of chronic cough (p=0.001). Thirty-six (43.9%) of cases and 40(16.5%) of controls had a history of carrying heavy objects (p=0.001). Among women involved in the study, 47(14.5%), 3(0.9%), 63(19.4%), 5(1.5%), 6(1.8%) had hypertension, diabetes mellitus and chronic constipation respectively (p=0.003, p=0.201, p=0.001). Regarding participants\u0026rsquo; BMI, 50(61.0%) of cases and 183(75.3%) of controls had BMI of 18.5-24.9 kg/m\u003csup\u003e2\u003c/sup\u003e (p=0.001) \u003cstrong\u003e(Table 3)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003ca name=\"_Toc24617562\"\u003e\u003c/a\u003e\u003cstrong\u003e\u0026nbsp;Determinants of \u003c/strong\u003e\u003cstrong\u003euterovaginal prolapse among study participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe odds of developing UVP concerning different characteristics of women were estimated by odds ratio using binary logistic regression analysis. Variables having a p-value of less than 0.2 at bivariate analysis were taken to multivariable analysis. In the final model, the odds of having UVP across each independent variable were adjusted for confounding effects. Accordingly, age, duration of labor, mode of delivery, family planning use, family history of UVP, and low BMI were predictor variables that remained significantly associated with UVP at p-value less than 0.05.\u003c/p\u003e\n\u003cp\u003eMultivariable logistic regression analysis indicated that women aged \u003cu\u003e\u0026gt;\u003c/u\u003e40 years had 10.5 times greater odds of experiencing uterovaginal prolapse compared to those aged \u0026lt;40 years\u0026nbsp; (AOR=10.49; 95%CI: 4.03, 27.35). Women who had a duration of labor greater or equal to 24 hours during the last childbirth had 8.32 times higher odds of developing UVP compared to those who stayed less than 24 hours (AOR=8.32; 95%CI: 3.58, 19.33). \u0026nbsp;Women who gave birth by instrumental delivery had 7.40 times higher odds of developing UVP compared to women who gave birth by cesarian section (AOR=7.40; 95%CI: 1.21, 45.28). Women who did not ever use family planning had 3.14 times higher odds of developing UVP compared to their counterparts (AOR=3.14; 95%CI: 1.32, 7.47). Similarly, women with a family history of UVP had 3.77 times higher odds of developing UVP compared to their counterparts (AOR=3.77; 95%CI: 1.10. 12.88). Also, underweight women had 5.3 times higher odds of developing UVP compared to women with normal weight (AOR=5.30; 95%CI: 1.83, 15.33).\u003c/p\u003e\n\u003cp\u003eHowever, the effect of residence, gravidity, parity, place of delivery, menopausal status, history of chronic cough, chronic constipation, and carrying heavy objects were no longer significant after adjusting for confounders \u003cstrong\u003e(Table 4)\u003c/strong\u003e.\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe main objective of the study was to identify the determinant factors of UVP among women attending gynecologic OPD at public hospitals in Western Ethiopia. Accordingly, many modifiable factors were identified to affect the occurrence of UVP.\u003c/p\u003e\n\u003cp\u003eDifferent studies reported that the risk of UVP increases with age [7,13,15,26,28]. This study also revealed that women aged \u0026ge;40 years had 10.49 times higher odds of experiencing UVP compared to women aged \u0026lt;40 years. This might be due to age-related weakening of pelvic supportive structures, decreased level of estrogen, and high parity in this age group. However, a study conducted in Gondar Dabat district, Ethiopia, reported a contradictory finding [33].\u003c/p\u003e\n\u003cp\u003eThe duration of labor great or equal to 24 hours was significantly associated with the development of uterovaginal prolapse. This finding is consistent with previous reports from India [25], Nepal [30], Tanzania[35], Nigeria [19], and Ethiopia [7]. This could be because prolonged labor causes more damage to supportive structures of the uterus and other pelvic organs. Prolonged labor can also be complicated by obstructed labor which might need aggressive interventions like operative deliveries that might worsen damage to already weakened structures.\u003c/p\u003e\n\u003cp\u003ePrevious studies indicated a controversial association between instrumental deliveries and pelvic prolapse. A study in Greater Baltimore Medical Center in Towson has suggested that operative delivery(forceps or vacuum) substantially increases the odds for pelvic organ prolapse[36] while a population-based study in Sweden [37] failed to show this association. Interestingly, this study identified a significant association between instrumental delivery and UVP.\u0026nbsp; \u0026nbsp;Women who delivered either by forceps or vacuum had 7.4 times higher odds of developing UVP compared to women who delivered by cesarian section. A possible explanation could be due to stretching and tearing as a result of excessive traction applied during difficult instrumental deliveries[31].\u003c/p\u003e\n\u003cp\u003eWomen who did not use family planning had 3.14 times higher odds of developing UVP compared to their counterparts. This finding is similar to the study conducted at Wolaita Sodo University Referral Hospital [32]. This is because mothers who do not use family planning have repeated deliveries during which cumulative effects of pushing down pain might damage the pelvic support structures. However, a study conducted in England [3] did not show an association between the utilization of family planning and the development of UVP.\u003c/p\u003e\n\u003cp\u003eIn this study, family history was found to be a predictor for UVP. Women with a family history of UVP had 3.77 times higher odds of developing UVP compared to their counterparts. This is consistent with studies conducted in Addis Ababa, Ethiopia [8], and Nepal [33]. Similarly, \u0026nbsp;a study conducted in Italy reported that the risk of urogenital prolapse was higher in women with a family history of prolapse as compared to women without a family history of prolapse [17]. This could be due to the presence of congenital connective tissue disorders in these families.\u003c/p\u003e\n\u003cp\u003eLike a report from Bahir Dar, Ethiopia [13], underweight (BMI \u0026lt;18.5 kg/m\u003csup\u003e2\u003c/sup\u003e) was also found to be a determinant of UVP in this study. \u0026nbsp;This is due to the possibility of micronutrient deficiencies which are necessary for connective tissue strength.\u0026nbsp; On the other hand, other studies showed that obesity (BMI \u0026ge;25 kg/m\u003csup\u003e2\u003c/sup\u003e) is a risk factor for UVP [15, 23,30]. \u003ca name=\"_Toc24617568\"\u003e\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eLimitations of this study include; small sample size that might lead to statistical imprecision; since participants were asked about some of their previous health-related events, it is subjected to recall bias; cases and controls were not matched by age, which might be an important contributor to the occurrence of UVP; and \u0026nbsp;the possibility of errors in measuring exposure variables of interest which might impact the internal validity of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONCLUSIONS: \u003c/strong\u003eAge \u0026ge; 40 years, prolonged labor, instrumental delivery, non-utilization of family planning, family history of UVP, and underweight were identified as determinant factors of uterovaginal prolapse. Therefore, creating awareness for women regarding possible risk factors and preventive measures of uterovaginal prolapse, training for health professionals on how to manage prolonged labor and how to use instrumental delivery cautiously, and further study that utilize strong designs are recommended.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance was obtained from Wollega University Institute of Health Sciences Ethical Review Board. Additionally, a letter of cooperation was written to respective hospitals by Wollega University Institute of Health Sciences. To obtain permission, hospital administrations were informed before starting data collection. All participants were given adequate information regarding the purpose, risk and benefit, and confidentiality of the study as described in the information sheet. Participation was fully voluntary and written informed consent was taken from each participant. Confidentiality of patient was kept and the information was merely used for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank Wollega University Institute of Health Sciences for funding this study. Especial thanks also go to all supervisors, data collectors, and study participants for their cooperation and support during the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGF, TT, and GK were involved in all components of this research, including conception, design, and supervision of data collection, data analysis and write up of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere was no funding source.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data sets used and analyzed for the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u0026nbsp; \u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors detail\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Nursing, College of Medicine and Health Sciences, Mettu University, Mettu, Ethiopia. \u003csup\u003e2\u003c/sup\u003eSchool of Medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia. \u003csup\u003e3\u003c/sup\u003eDepartment of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHowkins and Bourne, Shaw\u0026rsquo;s Textbook of Gynaecology. 17th edition. Elsevier India;2018.\u003c/li\u003e\n\u003cli\u003eAnthony R.B. Smith. Dewhurst\u0026rsquo;s Textbook of Obstetrics \u0026amp; Gynaecology. 9\u003csup\u003eth\u003c/sup\u003e Edmonds DK, editor. Australia: Blackwell publishing; 2018.\u003c/li\u003e\n\u003cli\u003eMant J, Painter R, Vessey M. Epidemiology of genital prolapse: Observations from the oxford family planning association study. BJOG An Int J Obstet Gynaecol. 1997;104(5):579\u0026ndash;85.\u003c/li\u003e\n\u003cli\u003eHardee K, Gay J, Blanc AK. Maternal morbidity: The neglected dimension of safe motherhood in the developing world. Glob Public Health. 2012;7(6):603\u0026ndash;17.\u003c/li\u003e\n\u003cli\u003eHakan Aytan, Devrim Ertun\u0026ccedil;, Ekrem C. Tok, Osman Yaşa HN. Prevalence of pelvic organ prolapse and related factors in a general female population. J Turk Soc Obs Gyneco. 2014;3:176\u0026ndash;80.\u003c/li\u003e\n\u003cli\u003eOkeke TC, Ani VC, Ezenyeaku CCT, Ikeako LC, Enwereji JO EK. An Audit of Uterovaginal Prolapse in Enugu, Southeast Nigeria. Am J Clin Med Res. 2013;1(1):23\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eMenur A, Segni H. Pelvic Organ Prolapse in Jimma University Specialized Hospital , Southwest Ethiopia. Ethiop J Heal Sci. 2012;22(2):85\u0026ndash;92.\u003c/li\u003e\n\u003cli\u003eHurissa T, Bekele D. One-Year Review of Pelvic Organ Prolapse At St. Paul \u0026rsquo; S Hospital Millennium Medical College, Addis Ababa Ethiopia. Ethiop J Reprod Heal. 2018;10(1):56\u0026ndash;61.\u003c/li\u003e\n\u003cli\u003eBerhane Y, Gossaye Y, Emmelin M, Hogberg U. Women\u0026rsquo;s health in a rural setting in societal transition in Ethiopia. 2001;53:1525\u0026ndash;39.\u003c/li\u003e\n\u003cli\u003eLagan AS, Lucia V, Rosa L. Pelvic organ prolapse : The impact on the quality of life and psychological well- being Pelvic organ prolapse : the impact on the quality of life and psychological well-being. J Psychosom Obstet 8 Gynecol. 2017;0(0):-000.\u003c/li\u003e\n\u003cli\u003eGjerde JL, Rortveit G, Muleta M, Adefris M, Blystad A. Living with pelvic organ prolapse: voices of women from Amhara region, Ethiopia. Int Urogynecol J. 2017;28(3):361\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eShrestha AD. Prevalence of Uterine Prolapse amongst Gynecology OPD Patients in Tribhuvan University Teaching Hospital in Nepal and its Socio-Cultural Determinants. Asian-Pacific Resour Res Cent Women. 2009;\u003c/li\u003e\n\u003cli\u003eAsresie A, Admassu E, Setegn T. Determinants of pelvic organ prolapse among gynecologic patients in Bahir Dar, North West Ethiopia: A case-control study. Int J Women's Health. 2016;8:713\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eAkter F, Gartoulla P, Oldroyd J, Islam RM. Prevalence of, and risk factors for, symptomatic pelvic organ prolapse in rural Bangladesh : a cross-sectional survey study. IntUrogynecolJ. 2016;\u003c/li\u003e\n\u003cli\u003eAwwad J, Sayegh R, Yeretzian J, Deeb ME. Prevalence, risk factors, and predictors of pelvic organ prolapse in Beruit, Lebanon : A community-based study. J North Am Menopause Soc. 2012;19(11):1235\u0026ndash;41.\u003c/li\u003e\n\u003cli\u003eBodner-Adler B, Shrivastava C, Bodner K. Risk factors for uterine prolapse in Nepal. Int Urogynecol J. 2007;18(11):1343\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eChiaffarino F, Chatenoud L, Dindelli M, Meschia M, Buonaguidi A, Amicarelli F, et al. Reproductive factors, family history, occupation and risk of urogenital prolapse in Milan, Italy. Eur J Obstet Gynecol Reprod Biol. 1999;82(1):63\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eEden E, Lezyonların P. The Incidence of Concomitant Precancerous Lesions in Cases Who Underwent Hysterectomy for Prolapse in Istanbul, Turkey. J Clin Anal Med. 2016;7(5).\u003c/li\u003e\n\u003cli\u003eEleje G, Udegbunam O, Ofojebe C, Adichie C. Determinants and management outcomes of pelvic organ prolapse in a low resource setting of Nnamdi Azikiwe University Teaching Hospital, Nnewi, south-east Nigeria. Ann Med Health Sci Res. 2014;4(5):796.\u003c/li\u003e\n\u003cli\u003eHenok A. Prevalence and factors associated with pelvic organ prolapse among pedestrian back-loading women in bench Maji Zone, Ethiopia . Ethiop J Health Sci. 2017;27(3):263-801.\u003c/li\u003e\n\u003cli\u003eHorst W, Barros J, Silva JC. Pelvic organ prolapse : prevalence and risk factors in a Brazilian population Brazil. Int Urogynecol J. 2016;\u003c/li\u003e\n\u003cli\u003eMenopausal P, Study I. Risk factors for genital prolapse in non-hysterectomized women around menopause Results from a large cross-sectional study in menopausal clinics in Italy. 2000;93:135\u0026ndash;40.\u003c/li\u003e\n\u003cli\u003eMs AG, Hartmann KE, Hellwege JN, Velez DR, Ms E, Ms TLE. Systematic Reviews Obesity and pelvic organ prolapse : a systematic review and meta-analysis of observational studies, Nashville, Tennesse. Am J Obstet Gynecol. 2017;217(1):11\u0026ndash;26.e3.\u003c/li\u003e\n\u003cli\u003ePandit U, Malla DS, Sharma PK. Age as risk factors associated in the genesis of uterovaginal prolapse (UVP) in Nepal. Nepal J Obstet Gynaecol. 2014;3(2):48\u0026ndash;50.\u003c/li\u003e\n\u003cli\u003eSujindra E, Himabindu N, Sabita P, Bupathy A. Determinants and treatment modalities of uterovaginal prolapse in Gandhi Medical College, India: A retrospective study. Indian J Heal Sci. 2015;8(1):36.\u003c/li\u003e\n\u003cli\u003eSwift SE, Pound T, Dias JK. Case-control study of etiologic factors in the development of severe pelvic organ prolapse in South Carolina, USA. Int Urogynecol J. 2001;12(3):187\u0026ndash;92.\u003c/li\u003e\n\u003cli\u003eThapa B, Rana G, Gurung S. Contributing factors of uterovaginal prolapse among women attending in Bharatpur Hospital, Nepal. J Chitwan Med Coll. 2015;4(3):38\u0026ndash;42.\u003c/li\u003e\n\u003cli\u003eVergeldt TFM, Weemhoff M, Inthout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence in Netherlands : a systematic review. IntUrogynecolJ. 2015;\u003c/li\u003e\n\u003cli\u003eYuk JS, Lee JH, Hur JY, Shin JH. The prevalence and treatment pattern of clinically diagnosed pelvic organ prolapse, Republic of Korea: A Korean National Health Insurance Database-based cross-sectional study 2009-2015. Sci Rep. 2018;8(1):4\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eThapa S, Angdembe M, Chauhan D, Joshi R. Determinants of pelvic organ prolapse among the women of the western part of Nepal: A case-control study. J Obstet Gynaecol Res. 2014;40(2):515\u0026ndash;20.\u003c/li\u003e\n\u003cli\u003eHanda et al. Pelvic Floor Disorders After Childbirth: Effect of Episiotomy, Perineal Laceration, and Operative Birth. J Obstet Gynaecol (Lahore). 2013;119(410):233\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eZinash Lema, Yemane Berhane MM. Determinants of Pelvic Organ Prolapse among Gynecological Cases in Wolaita Sodo University Referral Teaching Hospital , Southern Ethiopia : A Case-Control Study. 2015;5(21):1\u0026ndash;10.\u003c/li\u003e\n\u003cli\u003eSilwal M, Gurung R, Shrestha N, Gurung A, Ojha S. Prevalence and Factors Affecting Women with Uterine Prolapse in Lekhnath , Kaski , Nepal. J Gandaki Med Coll. 2016;09(2):52\u0026ndash;71.\u003c/li\u003e\n\u003cli\u003eBerihun MZ, Adefris M, Rortveit G, et al. Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study.\u0026nbsp;Int Urogynecol J.\u0026nbsp;2013;24(7):1135\u0026ndash;1143.\u003c/li\u003e\n\u003cli\u003eMasenga GG, Shayo BC, Rasch V. Prevalence and risk factors for pelvic organ prolapse in Kilimanjaro, Tanzania: A population based study in Tanzanian rural community,2018. PLoS ONE 13(4): e0195910. https://doi.org/10.1371/ journal.pone.0195910\u003c/li\u003e\n\u003cli\u003eHanda VL, Blomquist JL, Knoepp LR, Hoskey KA, McDermott KC, Mu\u0026ntilde;oz A. Pelvic floor disorders 5-10 years after vaginal or cesarean childbirth.\u0026nbsp;\u003cem\u003eObstet Gynecol\u003c/em\u003e. 2011;118(4):777-784. doi:10.1097/AOG.0b013e3182267f2f\u003c/li\u003e\n\u003cli\u003eTegerstedt G, Miedel A, Maehle-Schmidt M, Nyr\u0026eacute;n O, Hammarstr\u0026ouml;m M. Obstetric risk factors for symptomatic prolapse: a population-based approach. \u003cem\u003eAm J Obstet Gynecol. 2006 Jan; 194(1):75-81.\u003c/em\u003e\u003c/li\u003e\n\u003c/ol\u003e\n"},{"header":"Tables","content":"\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:.5in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;text-indent:-.5in;'\u003e\u003cstrong\u003e\u003cspan style='font-size: 10px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0); background-color: rgb(255, 255, 255);'\u003eTable 1:\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Socio demographic characteristics of women attending gynecologic OPD among cases and controls at public hospitals in Nekemte town, Western Ethiopia, 2019\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 4.8e+2pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 182.6pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;height: 24.8pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eCharacteristics of Respondents\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;height: 24.8pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eCases\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: 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style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e13(5.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e5(2.1)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97.75pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.527\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 182.6pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eReligion\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eProtestant\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Orthodox\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Muslim\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Other(Catholic, Adventist)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e50(61.0)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e25(30.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e6(7.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e1(1.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e150(61.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e55(22.6)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e35(14.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e3(1.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97.75pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.253\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 182.6pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eEducation of Women\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eNo education\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Primary(1-8 grade)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Secondary(9-12 grade)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;College and above\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", 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style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e76(31.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e35(14.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 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background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.010\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 182.6pt;border: none;padding: 0in 5.4pt;height: 85.7pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eOccupation\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", 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style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Government employee\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Daily laborer\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Farmer\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;border: none;padding: 0in 5.4pt;height: 85.7pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 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style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.022\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 182.6pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eMarital Status\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eSingle( single, divorced, widowed)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Married\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e3(3.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e79(96.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e8(3.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e235(96.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97.75pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.081\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 182.6pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eResidence\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eUrban\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Rural\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e28(34.1)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e54(65.9)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.15pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e108(44.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e135(55.6)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97.75pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.102\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:.5in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;text-indent:-.5in;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family: \"Times New Roman\", serif;'\u003eTable 2:\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Obstetrics and gynecologic history of women attending gynecologic OPD among cases and controls at public hospitals in Nekemte town, Western Ethiopia, 2019\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 4.8e+2pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eCharacteristics\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eCases\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eNumber (%)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77.95pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eControls\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eNumber (%)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.4pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003eP-Value\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eAge at first marriage\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u0026ge;18 years\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u0026lt;18 years\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e57(70.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e24(29.6)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77.95pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New 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style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.043\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eAge at first pregnancy\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u0026lt;20 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255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e36(44.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e45(55.6)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77.95pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e112(49.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e115(50.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 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initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n 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style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e23(28.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77.95pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp 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style=\"width: 69.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eMode of delivery (for the last child)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Spontaneous vaginal delivery\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Instrumental delivery\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Cesarean section\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e65(80.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp 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style=\"width: 77.95pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New 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style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.022\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eVaginal tear (during last child birth)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New 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style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e7(8.6)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e74(91.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77.95pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e14(6.4)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e205(93.6)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.002\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eSphincter damage (during the last child birth)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Yes\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;No\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e2(2.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e79(97.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77.95pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e2(0.9)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e217(99.1)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.007\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eEpisiotomy (during the last child birth)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Yes\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;No\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e5(6.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e76(93.8)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77.95pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e18(8.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e201(91.8)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.017\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eDuration of rest after delivery (for the last child)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u0026le;42 days\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 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style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e59(72.8)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e22(27.2)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77.95pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New 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255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.016\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eEver used family planning\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Yes\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;No\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e16(19.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e66(80.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77.95pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New 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style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eMenopausal status\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New 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style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e33(40.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan 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10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.55pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eFamily history of UVP\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Yes\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;No\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70.9pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e17(20.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e65(79.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77.95pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e13(5.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e230(94.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69.4pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:.25in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:.5in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;text-indent:-.5in;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family: \"Times New Roman\", serif;'\u003eTable 3:\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;Medical problems and history of pelvic surgery among cases and controls at public hospitals in Nekemte town, Western Ethiopia, 2019\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 4.5e+2pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 168.45pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eVariables\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.1pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eCases\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eNumber (%)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eControls\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eNumber (%)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.35pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003eP-Value\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 168.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92.1pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New 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style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e42(17.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.35pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family: \"Times New Roman\", serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;'\u003e0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:.25in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:.5in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;text-indent:-.5in;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eTable 4:\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eBivariate and multivariable logistic analysis of determinants of utero-vaginal prolapse among women attending gynecologic OPD at public hospitals in Nekemte town, Ethiopia, 2019\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 5.0e+2pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 171.9pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;height: 20.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eVariables\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58.5pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;height: 20.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eCases\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eN (%)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67.5pt;border-top: 1pt solid black;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;height: 20.1pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eControls\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 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style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eAge\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New 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255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 171.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003ePlace of delivery (for the last child)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Home\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Health facility\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e42(51.9)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e39(48.1)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e34(15.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e185(84.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1.5in;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e5.86(3.31,10.35)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e1.43(0.49,4.11)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 171.9pt;border: none;padding: 0in 5.4pt;height: 46.25pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eDuration of labor (for the last child)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u0026ge;24 hours\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u0026lt;24 hours\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58.5pt;border: none;padding: 0in 5.4pt;height: 46.25pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e54(66.7)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e27(33.3)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;height: 46.25pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e55(25.1)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e164(74.9)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1.5in;border: none;padding: 0in 5.4pt;height: 46.25pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e5.96(3.43,10.38)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99pt;border: none;padding: 0in 5.4pt;height: 46.25pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e8.32(3.58,19.33)*\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 171.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='line-height: 115%; font-family: \"Times New Roman\", serif;'\u003eMode of delivery (for the last child)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan 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style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e1.11(0.25,4.90)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e7.40(1.21,45.28)*\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 171.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eEver used family planning\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan 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style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e16(19.5)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan 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style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e3.14(1.32,7.47)*\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 171.9pt;border: none;padding: 0in 5.4pt;height: 34.2pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eMenopausal status\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp 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255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e21(8.6)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1.5in;border: none;padding: 0in 5.4pt;height: 34.2pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp 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style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003eFamily history of UVP\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Yes\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan 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style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e5.30(1.83,15.33)*\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e0.40(0.10,1.51)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"background-color: rgb(255, 255, 255);\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-family: \"Times New Roman\", serif;'\u003eNote:\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan style='font-size: 10px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0); background-color: rgb(255, 255, 255);'\u003e\u0026nbsp;⃰ represents statistical significance at p\u0026lt;0.05\u003c/span\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Case-control, Determinants, Utero-vaginal prolapse, women\t","lastPublishedDoi":"10.21203/rs.3.rs-27815/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-27815/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Uterovaginal prolapse is a significant public health concern in developing countries like Ethiopia where access to health care is limited. It significantly affects women’s health and productivity. Thus, it is very important to identify determinant factors and take preventive actions. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA hospital-based unmatched case-control study was conducted on 86 cases and 258 controls who attended gynecologic outpatient departments in Nekemte town, from May 1 to July 30/2019. Cases were women with grade II, III \u0026amp; IV uterovaginal prolapse \u0026nbsp;while controls were women free from uterovaginal prolapse but with other gynecologic diseases. Data were collected using pretested interviewer-administered structured questionnaires and measurements on height and weight were taken to calculate the body mass index of women. Data were entered using Epi Data version 3.1 and analysis was carried out by SPSS version 24.0. Descriptive, bivariate, and multivariable logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used and statistical significance was declared at p\u0026lt;0.05. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThis study revealed, age ≥40 years (AOR=10.49; 95%CI: 4.03, 27.35), duration of labor ≥24 hours (AOR=8.32; 95%CI: 3.58, 19.33), instrumental delivery (AOR=7.40; 95%CI: 1.21, 45.28), non- utilization of family planning (AOR=3.14; 95%CI: 1.32, 7.47) and underweight (BMI \u0026lt;18.5 kg/m\u003csup\u003e2\u003c/sup\u003e) 5.30 (AOR=5.30; 95%CI: 1.83, 15.33)\u0026nbsp;were determinants of utero vaginal prolapse. \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion: A\u003c/strong\u003ege ≥ 40 years, prolonged labor, instrumental delivery, non-utilization of family planning, and underweight were identified as determinant factors of uterovaginal prolapse. Thus, family planning\u003cem\u003e \u003c/em\u003eservice utilization and appropriate and timely obstetric care are advisable.\u003cem\u003e \u003c/em\u003e\u003c/p\u003e","manuscriptTitle":"Determinants of Utero-vaginal prolapse in Western Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2020-08-31 19:46:41","doi":"10.21203/rs.3.rs-27815/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2020-05-28 20:56:07","doi":"10.21203/rs.3.rs-27815/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"57e1b232-1577-465d-b9ec-449c33be6994","owner":[],"postedDate":"August 31st, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":109113,"name":"Preventive Medicine"},{"id":109114,"name":"Internal Medicine"}],"tags":[],"updatedAt":"2020-12-24T18:09:38+00:00","versionOfRecord":[],"versionCreatedAt":"2020-08-31 19:46:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-27815","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-27815","identity":"rs-27815","version":["v2"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}