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  • Title: Maternal mortality in rural Bangladesh: the Jamalpur District.
    Author: Khan AR, Jahan FA, Begum SF.
    Journal: Stud Fam Plann; 1986; 17(1):7-12. PubMed ID: 3485842.
    Abstract:
    During the 12-month period from September 1982 to August 1983, 9,317 live births and 58 maternal deaths were recorded in Melanda and Islampur upazilas in the Jamalpur district of rural Bangladesh, giving a maternal mortality rate of 62.3 per 10,000 live births. Maternal mortality was positively related to maternal age and parity, with the mortality risk rising very sharply beyond age 35 years, and beyond parity four among women aged 25-34 years in particular. The most common causes of maternal death were eclampsia (20.7 percent), septic abortion (20.7 percent), postpartum sepsis (10.3 percent), obstructed labor (10.3 percent), and antepartum and postpartum hemorrhage (10.3 percent). These findings indicate that family planning, by decreasing the likelihood of pregnancy after age 35 and parity four, can help reduce the proportion of women at risk of maternal mortality. This study was conducted to determine: the present rate, demographic correlates, and major causes of maternal mortality in rural Bangladesh; the pattern of health practices in relation to maternal mortality; the rate and pattern of neonatal mortality in rural areas; and the reliability of traditional birth attendants as reporters of maternal mortality-related data. During the 12-month period from September 1982 to August 1983, 9,317 live births and 58 maternal deaths were recorded in Melanda and Islampur upazilas in the Jamalpur district of rural Bangladesh, giving a maternal mortality rate of 62.3/10,000 live births. The age-specific maternal mortality rate is lowest in the 20-24 year old age group. Mortality risk increases with age after 29 years, particularly in the 35-39 and the 40-and-over groups. For all ages combined, mortality rates show a positive relation to parity. Although a positive relationship between parity and mortality is visible in the 25-34 group, the relationship is negative in the 35-and-over group. The single most common cause of death was septic abortion. Other causes include eclampsia (20.7%), delivery complications including obstructed labor, retained placenta (17.2%), postpartum sepsis (10.3%), and hemorrhage (10.3%). The classic triad of causes of infection--eclampsia--hemorrhage, accounted for 68.9% of all maternal deaths in the study area; direct obstetric causes accounted for 86.2% of all maternal deaths. The positive correlation between maternal age and maternal mortality risk found in the study indicates that childbearing in women aged above 35 years is significantly more hazardous than in younger women. A high mortality risk was also found among high parity (4) women. Family planning can reduce the risk of maternal mortality.
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