title: Maternal morbidity in early pregnancy in rural northern Bangladesh.
abstract: OBJECTIVE
  To determine the burden of maternal morbidity in early pregnancy in rural northern Bangladesh.
  
  
  METHODS
  A cross-sectional analysis was performed on baseline morbidity data from 42 896 pregnant women enrolled in a vitamin A supplementation trial. One-week histories for 31 defined symptoms were collected at 5-12 weeks of gestation. Ten illnesses were defined, compatible with ICD-10 diagnoses and WHO definitions. Prevalence, duration, and treatment-seeking behaviors were determined for each symptom and illness. Risk of wasting malnutrition was compared between symptomatic and asymptomatic women.
  
  
  RESULTS
  In total, 93.1% of women reported at least 1 symptom. The most frequent symptoms were poor appetite (53.3%), vaginal discharge (48.7%), and nausea (48.1%), each of which lasted 22-27 days. The most prevalent illnesses were anemia (36.4%), morning sickness (17.2%), excessive vomiting (7.0%), and reproductive tract infections (6.7%). Symptoms that prompted treatment seeking included jaundice, high-grade fever, and swelling of hands and face. Odds ratios for malnutrition were higher among women with symptoms of anemia (1.30; 95% confidence interval [CI], 1.24-1.36), vaginal discharge (1.37; 95% CI, 1.31-1.43), and high-grade fever (1.23; 95% CI, 1.10-1.37) than among those without symptoms.
  
  
  CONCLUSIONS
  Women in rural Bangladesh report substantial morbidity in the first trimester.
authors.affiliation: Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Kim
authors.forename: Alain
authors.initials: A
authors.lastname: Labrique
authors.forename: Keith P
authors.initials: KP
authors.lastname: West
authors.forename: Mahbubur
authors.initials: M
authors.lastname: Rashid
authors.forename: Abu A
authors.initials: AA
authors.lastname: Shamim
authors.forename: Hasmot
authors.initials: H
authors.lastname: Ali
authors.forename: Barkat
authors.initials: B
authors.lastname: Ullah
authors.forename: Lee
authors.initials: L
authors.lastname: Wu
authors.forename: Allan
authors.initials: A
authors.lastname: Massie
authors.forename: Sucheta
authors.initials: S
authors.lastname: Mehra
authors.forename: Rolf
authors.initials: R
authors.lastname: Klemm
authors.forename: Parul
authors.initials: P
authors.lastname: Christian
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D044342:Malnutrition / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000503:physiopathology; D011261:Pregnancy Trimester, First; D016032:Randomized Controlled Trials as Topic; D012424:Rural Population; D019282:Wasting Syndrome / Q000453:epidemiology*; D055815:Young Adult