Health conditions of pregnant women and perinatal mortality in a slum of Dhaka city, Bangladesh

Abstract

Objective: Examine the association between perinatal mortality with health conditions, and treatment-seeking behaviour of pregnant women in a slum population of Dhaka city in Bangladesh. Methodology: A cohort of 2,007 pregnant women with a community setting was studied between June 1994 and January 1997. Women who, according to their last menstruation date, had less than 21 weeks of amenorrhoea, were considered for the study. The women were recruited from two antenatal clinics run by Radda Barnen, a large organization established in Mirpur, and from house-to-house survey in the catchment area of Radda Barnen. Those who signed a consent form were interviewed. The women were followed from 21 weeks of gestation to pregnancy termination. Information was collected on height, weight, mid-upper arm circumference (MUAC), haemoglobin, blood pressure, incidence of illnesses, and their treatments. Socioeconomic information was collected during the recruitment of the women, and information on the type of pregnancy termination was collected within 3 days of termination. Stillbirth or mortality of the newborns within 3 days of delivery was taken as the indicator of perinatal mortality. Results: Perinatal mortality was 60.3 per 1,000 livebirths (stillbirth ratio was 40.5 and 0-3-day mortality was 18.8 per 1,000 live-births). The logistic regression analysis showed that eclampsia, history of blood loss during pregnancy, hypertension, haemorrhage, and other infections were significant risk factors for perinatal mortality. Intrau-terine device used within the last two years preceding the present conception was also a significant risk factor for perinatal mortality. Body mass index or heights were not associated with perinatal mortality. Perinatal mortality was negatively associated with the number of visits to medical professionals during pregnancy. The educated women had significantly lower perinatal mortality than the uneducated ones, after controlling for demographic, biomedical and economic factors Conclusion: Access to medical care during pregnancy can substantially reduce perinatal mortality among the poor women in the urban slums.