Burden of preconception morbidity in women of reproductive age from an urban setting in North India

PLoS One. 2020 Jun 18;15(6):e0234768. doi: 10.1371/journal.pone.0234768. eCollection 2020.

Abstract

Background: There is a growing interest in the life course approach for the prevention, early detection and subsequent management of morbidity in women of reproductive age to ensure optimal health and nutrition when they enter pregnancy. Reliable estimates of such morbidities are lacking. We report the prevalence of health or nutrition-related morbidities, specifically, anemia, undernutrition, overweight and obesity, sexually transmitted infections (STIs) or reproductive tract infections (RTIs), diabetes or prediabetes, hypothyroidism, hypertension, and depressive symptoms, during the preconception period among women aged 18 to 30 years.

Methods: A cross-sectional study was conducted among 2000 nonpregnant married women aged 18 to 30 years with no or one child who wished to have more children in two low- to middle-income urban neighborhoods in Delhi, India, in the context of a randomized controlled trial. STIs and RTIs were measured by symptoms and signs, blood pressure by a digital device, height by stadiometer and weight by a digital weighing scale. A blood specimen was taken to screen for anemia, diabetes, thyroid disorders and syphilis. Maternal depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Multivariable logistic regression analysis was performed to identify sociodemographic factors associated with individual morbidity.

Results: Overall, 58.7% of women were anemic; 16.5%, undernourished; 26%, overweight or obese; 13.2%, hypothyroid; and 10.5% with both symptoms and signs of STIs/RTIs. There was an increased risk of RTI/STI symptoms and signs in undernourished women and an increased risk of diabetes or prediabetes in overweight or obese women. An increased risk of undernutrition was also observed in women from lower categories of wealth quintiles. A decreased risk of moderate to severe anemia was seen in overweight women and those who completed at least secondary education.

Conclusions: Our findings show a high burden of undernutrition, anemia, RTIs, hypothyroidism and prediabetes among women in the study. This information will aid policymakers in planning special programs for women of reproductive age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anemia / complications
  • Anemia / pathology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / etiology
  • Female
  • Humans
  • Hypothyroidism / pathology
  • India / epidemiology
  • Morbidity
  • Obesity / complications
  • Obesity / pathology
  • Prevalence
  • Reproductive Tract Infections / epidemiology
  • Reproductive Tract Infections / pathology*
  • Risk Factors
  • Severity of Illness Index
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / pathology*
  • Young Adult

Grants and funding

Initials of the authors who received each award: NB Grant numbers awarded to each author: BIRAC/GCI/0085/03/14-ACT) and Grant ID OPP1191052 The full name of each funder: Biotechnology Industry Research Assistance Council (BIRAC), Department of Biotechnology, Government of India under the Grand Challenges India-All Children Thriving initiative and the Bill & Melinda Gates Foundation, USA. URL of each funder website: https://birac.nic.in/; https://www.gatesfoundation.org/ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.