Determinants of maternal morbidity during pregnancy in urban Bangladesh

Zakir Hossain; Nilima Afroz; Sabina Sharmin; Sayema Sharmin; Enamul Kabir

doi:10.1371/journal.pone.0268487

Determinants of maternal morbidity during pregnancy in urban Bangladesh

PLoS One. 2023 Feb 24;18(2):e0268487. doi: 10.1371/journal.pone.0268487. eCollection 2023.

Authors

Zakir Hossain¹, Nilima Afroz², Sabina Sharmin¹, Sayema Sharmin¹, Enamul Kabir³

Affiliations

¹ Department of Statistics, University of Dhaka, Dhaka, Bangladesh.
² Road Transport and Highways Division, Ministry of Road Transport and Bridges, Dhaka, Bangladesh.
³ School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Australia.

Abstract

Background: Maternal morbidities especially life-threatening pregnancy complications are major health concerns in developing countries. The main aim is to investigate the prevalence of maternal morbidity during pregnancy and its determinants among women from urban areas of Bangladesh.

Methods: The secondary data were used and extracted from the latest Bangladesh Urban Health Survey (BUHS) 2013. Several statistical models: Poisson, negative binomial (NB) and mixed Poisson were adapted and compared to explore the best model for investigating potential determinants of maternal morbidity. Pearson chi-square statistic was used for the detection of overdispersion in the data. Results Overall 13.5% of the urban women in Bangladesh suffered from at least two pregnancy complications. The study detected the overdispersion existing in the maternal morbidity count data and found the NB regression as the best choice for analyzing the data because of its smallest Akaike information criterion. Administrative division (Rangpur: p = 0.003, incidence rate ratio, IRR = 1.34, 95% confidence interval, CI: 1.11 to 1.63; Sylhet: p = 0.006, incidence rate ratio, IRR = 1.42, 95% CI: 1.11 to 1.82), unwanted pregnancy (p<0.001, IRR = 1.25, 95% CI: 1.11 to 1.40), place of delivery (p<0.001, IRR = 1.68, 95% CI: 1.53 to 1.86) and wealth index (Poor: p<0.001, IRR = 1.34, 95% CI: 1.19 to 1.50; Middle: p = 0.003, IRR = 1.21, 95% CI: 1.08 to 1.36) were found to be statistically significant determinants for maternal morbidity during pregnancy among the urban women in Bangladesh.

Conclusions: Urban women in Bangladesh with an unwanted pregnancy, from the poor/middle-income group; and living in Rangpur and Sylhet divisional cities have a higher risk of maternal morbidity during pregnancy. Study findings may help the government and relevant authorities to take necessary steps for reducing maternal morbidity and mortality due to pregnancy-related complications.

Copyright: © 2023 Hossain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bangladesh / epidemiology
Female
Health Surveys
Humans
Morbidity
Pregnancy
Pregnancy Complications* / epidemiology
Urban Population

Grants and funding

This work was partially funded by the University of Dhaka and University of Grants Commission, Bangladesh. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.