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Open Defecation Adversely Affects Pregnancy Outcome

Poor sanitation practices linked to pregnancy outcomes like preterm birth, low birth weight

Published: 09th July 2015 05:50 AM  |   Last Updated: 09th July 2015 05:50 AM   |  A+A-

BHUBANESWAR: Even as Odisha battles with high infant mortality (IMR) and maternal mortality (MMR) rates along with serious challenges of child stunting and underweight, sanitation insecurity is one of the major contributors to the malaise, a latest study says.

Poor sanitation practices such as open defecation among pregnant women have been linked to adverse pregnancy outcomes (APOs), which include both preterm birth and low birth weight and other complications, on the basis of an extensive study conducted by researchers at two rural pockets of the State.

The researchers led by Bijaya K Padhi from Asian Institute of Public Health, Bhubaneswar enrolled 670 women during the first trimester of their pregnancy in Lathikata and Kuarmunda blocks of tribal-dominated Sundargarh district along with Balianta and Balipatna blocks of the coastal and more developed Khurda district. They recorded information about toilet access and sanitation practices for each woman at enrolment and followed them through pregnancy until birth.

They observed that nearly two-thirds of the women practiced open defecation and a quarter experienced an adverse pregnancy outcome, most commonly a preterm birth and/or having a baby with low birth weight. While nearly 29 per cent suffered APOs, as high as 19.4 per cent had preterm births and 14.2 per cent had babies with low birth weight. Around 1.6 per cent had spontaneous abortions while almost 1 per cent had still births.

The study ‘Risk of Adverse Pregnancy Outcomes among Women Practicing Poor Sanitation in Rural India: A Population-Based Prospective Cohort Study’ conducted in association with College of Public Health, University of Iowa; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine; Rollins School of Public Health, Emory University, Atlanta and College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska has been published in this week’s PLOS medicine journal.

Preterm and low birth weight are critical determinants of child survival, disabilities, stunting and also enhance risk of onset of non-communicable diseases like diabetes and cardiac diseases in the long-term. The problem has specific significance for Odisha which has the highest IMR of 51 per 10,000 births and MMR of 221 per lakh deliveries while over 40 per cent of children in the 3-5 age are underweight and 45 per cent stunted.

The State might have recorded impressive economic growth in the last decade and half but it still lags in social indices like improved sanitation services. In 2011, only 18.2 per cent households had access to improved latrine while more than two-thirds of the total households still continue to practice open defecation.

Dr Pinaki Panigrahi, senior author of this paper from University of Nebraska, College of Public Health said, “This study indicates that sanitation is an important dimension of women’s health and distinct from social class and caste.”

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