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Poor sanitation causes adverse pregnancy outcomes: New study

Poor sanitation, open defecation and lack of toilets are some very common sights in India – especially in the rural sides. These practices cause infection and leads to poor health. Now a new study has shown that they increase the risk of adverse pregnancy outcomes (APO) too.


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Bijaya K Padhi and his coworkers from the Asian Institute of Public Health conducted a study by registering 670 women during the first trimester of their pregnancy. They noted information about their toilet access and sanitation practices, besides clinical data, socio-demographic data, weight and height for each woman and followed them throughout their pregnancy until they gave birth.

The research team found that almost two-thirds of the women carried out open defecation and a quarter of them underwent an APO, most ordinarily a preterm birth and/or delivering a baby with low birth weight.

After alteration with other confounding factors they noticed that those pregnant women who carried out open defecation had more risk of suffering APO and preterm birth, but no low birth weight compared to those who used a latrine. The adjusted odds ratio was 2.38 and 2.22, respectively. These discoveries were independent of poverty, caste and religion.

The findings of this research that was done in tow villages of Odisha – a state that is situated in the eastern part of India, reflected that the women who carried out open defecation during pregnancy were more prone to adverse pregnancy outcomes and preterm birth than those who used a latrine. They also proved that the relation between open defecation and APO is not justified by poverty.

However, the research team has insisted that before drafting apt public heath interventions to lessen the load of APO, further studies are required to establish the socio-behavioral and/or biological basis of the relation between poor sanitation and APOs.

The study informed that poor sanitation causes APO by endorsing infection or producing stress during pregnancy. Pregnant women might check their consumption of food and water in order to ignore using the insufficient toilet facilities that in return affects the health of the fetus.

The World Health Organization (WHO) and UNICEF Joint Monitoring Programme for Water Supply and Sanitation guesstimated that 1.1 billion people practiced open defecation, across the world. In India, with 57 deaths per 1,000 live births Odisha has the highest infant mortality rate. Only 18.2 percent of the households have entrée to developed latrine with 75 percent carrying out open defecation.

The study further said that most preterm births occur in Asia and sub-Saharan Africa with figures exceeding the 60 percent mark. In 2010, India alone saw almost 47 percent of all births (13 million) having a low birth weight.

The study has been published in the journal PLOS Medicine.

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