OBJECTIVES: This study examined the risk factors of mortality related to pregnancy for the first year post partum in a cohort of 25,580 pregnancies. STUDY DESIGN: Longitudinal cohort follow-up. METHODS: Details of socio-economic status, mid-upper arm circumference (MUAC), diet, illness, work, substance use and previous pregnancy history were collected during early to mid-gestation, and these women were followed for 1 year post partum. All-cause mortality rates per 100,000 pregnancies were calculated for deaths during pregnancy or up to 42 days post partum (early period) and 43-364 days post partum (late period). Odds ratios (OR) of mortality were estimated using five groups of risk factors: biological; morbidity; dietary; lifestyle; and socio-economic. Significant factors within each group were included in a single risk model for each time period. RESULTS: Early and late pregnancy-related mortality rates were 469 [95% confidence interval (CI) 385-553] and 254 (95% CI 192-316), respectively. Maternal age > or = 35 years was associated with a three- to four-fold increase in mortality, whereas increasing parity conferred increasing protection. In the final model, a larger MUAC and consumption of dark green leaves were associated with decreased risk of death in the early period (OR 0.76, 95% CI 0.67-0.87 and 0.64, 95% CI 0.41-0.99, respectively). A larger MUAC was also associated with a lower risk of death in the late period. Diarrhoea/dysentery and pre-eclampsia were associated with increased risk of death in the early period (OR 2.78, 95% CI 1.40-5.51 and 2.95, 95% CI 1.48-5.90, respectively). Factors weakly associated (P<0.1) with mortality in both periods included night blindness, strenuous work activity and cigarette smoking. No socio-economic factors were significant in the models. CONCLUSIONS: Maternal age, parity, MUAC, diet and illness in early to mid-gestation were associated with risk of death during pregnancy and the first year post partum in rural Nepal.
OBJECTIVES: This study examined the risk factors of mortality related to pregnancy for the first year post partum in a cohort of 25,580 pregnancies. STUDY DESIGN: Longitudinal cohort follow-up. METHODS: Details of socio-economic status, mid-upper arm circumference (MUAC), diet, illness, work, substance use and previous pregnancy history were collected during early to mid-gestation, and these women were followed for 1 year post partum. All-cause mortality rates per 100,000 pregnancies were calculated for deaths during pregnancy or up to 42 days post partum (early period) and 43-364 days post partum (late period). Odds ratios (OR) of mortality were estimated using five groups of risk factors: biological; morbidity; dietary; lifestyle; and socio-economic. Significant factors within each group were included in a single risk model for each time period. RESULTS: Early and late pregnancy-related mortality rates were 469 [95% confidence interval (CI) 385-553] and 254 (95% CI 192-316), respectively. Maternal age > or = 35 years was associated with a three- to four-fold increase in mortality, whereas increasing parity conferred increasing protection. In the final model, a larger MUAC and consumption of dark green leaves were associated with decreased risk of death in the early period (OR 0.76, 95% CI 0.67-0.87 and 0.64, 95% CI 0.41-0.99, respectively). A larger MUAC was also associated with a lower risk of death in the late period. Diarrhoea/dysentery and pre-eclampsia were associated with increased risk of death in the early period (OR 2.78, 95% CI 1.40-5.51 and 2.95, 95% CI 1.48-5.90, respectively). Factors weakly associated (P<0.1) with mortality in both periods included night blindness, strenuous work activity and cigarette smoking. No socio-economic factors were significant in the models. CONCLUSIONS: Maternal age, parity, MUAC, diet and illness in early to mid-gestation were associated with risk of death during pregnancy and the first year post partum in rural Nepal.
Authors: Kenneth Hill; Shams El Arifeen; Michael Koenig; Ahmed Al-Sabir; Kanta Jamil; Han Raggers Journal: Bull World Health Organ Date: 2006-03-22 Impact factor: 9.408
Authors: P Christian; K P West; S K Khatry; J Katz; S R Shrestha; E K Pradhan; S C LeClerq; R P Pokhrel Journal: Int J Epidemiol Date: 1998-04 Impact factor: 7.196
Authors: K P West; R P Pokhrel; J Katz; S C LeClerq; S K Khatry; S R Shrestha; E K Pradhan; J M Tielsch; M R Pandey; A Sommer Journal: Lancet Date: 1991-07-13 Impact factor: 79.321
Authors: J Katz; S K Khatry; K P West; J H Humphrey; S C Leclerq; E Kimbrough; P R Pohkrel; A Sommer Journal: J Nutr Date: 1995-08 Impact factor: 4.798
Authors: Joanne Katz; Keith P West; Subarna K Khatry; Parul Christian; Steven C LeClerq; Elizabeth Kimbrough Pradhan; Sharada Ram Shrestha Journal: Bull World Health Organ Date: 2003-11-25 Impact factor: 9.408
Authors: P Christian; K P West; J Katz; E Kimbrough-Pradhan; S C LeClerq; S K Khatry; S R Shrestha Journal: Eur J Clin Nutr Date: 2004-02 Impact factor: 4.016
Authors: Parul Christian; Subarna K Khatry; Joanne Katz; Elizabeth K Pradhan; Steven C LeClerq; Sharada Ram Shrestha; Ramesh K Adhikari; Alfred Sommer; Keith P West Journal: BMJ Date: 2003-03-15
Authors: Joanne Katz; Subarna K Khatry; Steven C LeClerq; Keith P West; Parul Christian Journal: Matern Child Nutr Date: 2010-07-01 Impact factor: 3.092
Authors: Carine Ronsmans; S Scott; S N Qomariyah; E Achadi; D Braunholtz; T Marshall; E Pambudi; K H Witten; W J Graham Journal: Bull World Health Organ Date: 2009-06 Impact factor: 9.408
Authors: Carine Ronsmans; Mahbub Elahi Chowdhury; Marge Koblinsky; Anisuddin Ahmed Journal: Bull World Health Organ Date: 2009-10-14 Impact factor: 9.408
Authors: David W Wee; Luke C Mullany; Joanne Katz; Subarna K Khatry; Steven C LeClerq; James M Tielsch Journal: Am J Epidemiol Date: 2010-08-08 Impact factor: 4.897
Authors: Mai-Lei Woo Kinshella; Shazmeen Omar; Kerri Scherbinsky; Marianne Vidler; Laura A Magee; Peter von Dadelszen; Sophie E Moore; Rajavel Elango Journal: Adv Nutr Date: 2021-12-01 Impact factor: 8.701
Authors: Shegufta S Sikder; Alain B Labrique; Abu A Shamim; Hasmot Ali; Sucheta Mehra; Lee Wu; Saijuddin Shaikh; Keith P West; Parul Christian Journal: BMC Pregnancy Childbirth Date: 2014-10-04 Impact factor: 3.007