A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health shows that over one-quarter of women in rural Bangladesh experience complications during pregnancy, with hemorrhage and sepsis as the most commonly reported complications. The majority of childbirths in rural Bangladesh are at home with no trained health professional in attendance. The study was published in the October 4 edition of Biomed Central Pregnancy and Childbirth.
The complications reported by women highlight the need for greater access to health care in rural settings.
For their study, researchers tracked over 42,000 women throughout their pregnancies and the postpartum period for information on symptoms and nutritional status. The study was conducted as part of a broader randomized controlled trial in northwestern rural Bangladesh. The trial, known as JiVitA, is a maternal and child health and nutrition research project site managed by the Johns Hopkins Bloomberg School of Public Health. Researchers have collected data for over a decade that have been used to inform national and regional public health policies.
The study found that older women, women with past pregnancy complications — including miscarriage and stillbirth — and women who reported that neither partner had wanted the pregnancy were more likely to report a complication.
“In settings such as rural Bangladesh, more than 75 percent of all births occur at home,” said Alain Labrique, PhD, assistant professor in the Bloomberg School’s Department of International Health and second author of the study. “For these situations, population-based data are vital to understand ways to address the high burden of pregnancy-related morbidity.”
Policies that address things such as early marriage, limited availability of contraception and maternal under-nutrition could lessen the risk of pregnancy-related complications in rural Bangladesh, the study’s authors note.
“Risk Factors for Reported Obstetric Complications and Near Misses in Rural Northwest Bangladesh: Analysis from a Prospective Cohort Study” was written by Shegufta S Sikder, Alain Labrique, Abu A Shamim, Hasmot Ali, Sucheta Mehra, Lee Wu, Saijuddin Shaikh, Keith P West, and Parul Christian.
Financial support for the parent JiVitA-3 trial was provided by the Bill & Melinda Gates Foundation, Seattle, Washington (Global Control of Micronutrient Deficiency, Grant 614). Partial support for this data analysis was provided by the Fogarty International Center Training Grant (D43TW7587) at the National Institutes for Health.
Please visit the JiVitA website for more information about the trial.
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