Risk of death following pregnancy in rural Nepal

• Ngā kaituhi matua: Pradhan Elizabeth Kimbrough (Author), West Jr Keith P. (Author), Katz Joanne (Author), Christian Parul (Author), Khatry Subarna K. (Author), LeClerq Steven C. (Author), Dali Sanu Maiya (Author), Shrestha Sharada Ram (Author)
• Hōputu: Pukapuka
• I whakaputaina: The World Health Organization, 2002-01-01T00:00:00Z.
• Ngā marau: article
• Urunga tuihono: Connect to this object online.
• Notes: 0042-9686
• Keywords: Maternal mortality; Pregnancy complications/mortality; Pregnancy complications/etiology; Puerperium; Risk factors; Prospective studies; Cohort studies; Nepal; Public aspects of medicine; RA1-1270
• Source: Bulletin of the World Health Organization, Vol 80, Iss 11, Pp 887-891 (2002)

OBJECTIVE: To investigate the length of time following pregnancy during which the risk of mortality was elevated among women in rural Nepal. METHODS: An analysis was performed of prospective data on women participating in the control group of a large, population-based trial. Weekly visits were made for three years to 14 805 women aged 14-45 years. Pregnancy and vital status were assessed. A total of 7325 pregnancies were followed. Mortality during and following pregnancy, expressed on a person-time basis, was compared to referent mortality unrelated to pregnancy (52 weeks after pregnancy) in the same cohort. FINDINGS: The relative risk (RR) of death during pregnancy but before the onset of labour was 0.93 (95% confidence interval (CI): 0.38-2.32). During the perinatal period, defined as lasting from the onset of labour until seven days after outcome, the RR of death was 37.02 (95% CI: 15.03-90.92). The RR for 2 to 6 weeks, 7 to 12 weeks, and 13 to 52 weeks after pregnancy were 4.82, 2.59 and 1.01 with 95% CI of 1.77-13.07, 0.81-8.26 and 0.40-2.53, respectively. The RR of death was 2.21 (95% CI. 1.03-4.71) during the conventional maternal mortality period (pregnancy until 6 weeks after outcome). It was 2.26 (95% CI: 1.05-4.90) when the period was extended to 12 weeks after pregnancy outcome. CONCLUSION: The risk of mortality associated with pregnancy should be assessed over the first 12 weeks following outcome instead of over the first 6 weeks.