Estimating the burden of maternal and neonatal deaths associated with jaundice in Bangladesh: possible role of hepatitis E infection.
OBJECTIVE
We estimated the population-based incidence of maternal and neonatal mortality associated with hepatitis E virus (HEV) in Bangladesh.


METHODS
We analyzed verbal autopsy data from 4 population-based studies in Bangladesh to calculate the maternal and neonatal mortality ratios associated with jaundice during pregnancy. We then reviewed the published literature to estimate the proportion of maternal deaths associated with liver disease during pregnancy that were the result of HEV in hospitals.


RESULTS
We found that 19% to 25% of all maternal deaths and 7% to 13% of all neonatal deaths in Bangladesh were associated with jaundice in pregnant women. In the published literature, 58% of deaths in pregnant women with acute liver disease in hospitals were associated with HEV.


CONCLUSIONS
Jaundice is frequently associated with maternal and neonatal deaths in Bangladesh, and the published literature suggests that HEV may cause many of these deaths. HEV is preventable, and studies to estimate the burden of HEV in endemic countries are urgently needed.
International Centre for Diarrheal Diseases Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh. egurley@icddrb.org
Emily S
ES
Gurley
Amal K
AK
Halder
Peter K
PK
Streatfield
Hossain M S
HM
Sazzad
Tarique M Nurul
TM
Huda
M Jahangir
MJ
Hossain
Stephen P
SP
Luby
D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D016751:Hepatitis E / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007565:Jaundice / Q000401:mortality*; D008428:Maternal Mortality; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000401:mortality*; D055815:Young Adult