scholarly journals Impact of an improved biomass stove on birth outcomes in rural Nepal: A cluster-randomized, step-wedge trial

2016 ◽  
Vol 82 (3) ◽  
pp. 576
Author(s):  
J. Katz ◽  
J.M. Tielsch ◽  
S.K. Khatry ◽  
L. Shrestha ◽  
P. Breysse ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Biomass Stove ◽  
Cluster Randomized ◽  
Rural Nepal

scholarly journals Quantifying the association of natal household wealth with women’s early marriage in Nepal

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12324
Author(s):  
Akanksha A. Marphatia ◽  
Naomi M. Saville ◽  
Dharma S. Manandhar ◽  
Mario Cortina-Borja ◽  
Jonathan C. K. Wells ◽  
...  
Keyword(s):  
Household Wealth ◽  
Early Marriage ◽  
Physical And Mental Health ◽  
Full Sample ◽  
Child Undernutrition ◽  
Household Poverty ◽  
Global Health Issue ◽  
And Gender ◽  
Cluster Randomized ◽  
Rural Nepal

Background Women’s early marriage (<18 years) is a critical global health issue affecting 650 million women worldwide. It is associated with a range of adverse maternal physical and mental health outcomes, including early childbearing, child undernutrition and morbidity. Poverty is widely asserted to be the key risk factor driving early marriage. However, most studies do not measure wealth in the natal household, but instead, use marital household wealth as a proxy for natal wealth. Further research is required to understand the key drivers of early marriage. Methods We investigated whether natal household poverty was associated with marrying early, independently of women’s lower educational attainment and broader markers of household disadvantage. Data on natal household wealth (material asset score) for 2,432 women aged 18–39 years was used from the cluster-randomized Low Birth Weight South Asia Trial in lowland rural Nepal. Different early marriage definitions (<15, <16, <17 and <18 years) were used because most of our population marries below the conventional 18-year cut-off. Logistic mixed-effects models were fitted to estimate the probabilities, derived from adjusted Odds Ratios, of (a) marrying at different early ages for the full sample and for the uneducated women, and (b) being uneducated in the first place. Results Women married at median age 15 years (interquartile range 3), and only 18% married ≥18 years. Two-thirds of the women were entirely uneducated. We found that, rather than poverty, women’s lower education was the primary factor associated with early marriage, regardless of how ‘early’ is defined. Neither poverty nor other markers of household disadvantage were associated with early marriage at any age in the uneducated women. However, poverty was associated with women being uneducated. Conclusion When assets are measured in the natal household in this population, there is no support for the conventional hypothesis that household poverty is associated with daughters’ early marriage, but it is associated with not going to school. We propose that improving access to free education would both reduce early marriage and have broader benefits for maternal and child health and gender equality.

scholarly journals Nausea, vomiting and poor appetite during pregnancy and adverse birth outcomes in rural Nepal: an observational cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Amanda Regodón Wallin ◽  
James M Tielsch ◽  
Subarna K Khatry ◽  
Luke C Mullany ◽  
Janet A Englund ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
First Trimester ◽  
Observational Cohort Study ◽  
Limited Resources ◽  
Poor Appetite ◽  
Observational Cohort ◽  
Rural Nepal

Abstract Background Nausea and vomiting are experienced by a majority of pregnant women worldwide. Previous studies have yielded conflicting results regarding their impact on birth outcomes and few studies have examined this relationship in settings with limited resources. We aimed to determine the effect of nausea, vomiting and poor appetite during pregnancy on birth outcomes in rural Nepal. Methods Observational cohort study using data collected in two randomized, community-based trials to assess the effect of influenza immunization during pregnancy on reproductive and respiratory outcomes among pregnant women and their offspring. Pregnant women in Sarlahi District, Nepal were recruited from 2011 to 2013. Exposure was defined as nausea, vomiting or poor appetite at any point during pregnancy and by trimester; symptoms were recorded monthly throughout pregnancy. Adverse outcomes were low birth weight (LBW), preterm birth and small for gestational age (SGA). Adjusted relative risks (aRR) with 95% CIs are reported from Poisson regressions with robust variance. Results Among 3,623 pregnant women, the cumulative incidence of nausea, vomiting or poor appetite was 49.5% (n = 1793) throughout pregnancy and 60.6% (n = 731) in the first trimester. Significantly higher aRRs of LBW and SGA were observed among women experiencing symptoms during pregnancy as compared to symptom free women (LBW: aRR 1.20; 95% CI 1.05 1.28; SGA: aRR 1.16; 95% CI 1.05 1.28). Symptoms in the first trimester were not significantly associated with any of the outcomes. In the second trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.17; 95% CI 1.01 1.36; SGA: aRR 1.16; 95% CI 1.05 1.29) and a significantly lower aRR for preterm birth (aRR 0.75; 95% CI 0.59 0.96). In the third trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.20; 95% CI 1.01 1.43; SGA: aRR 1.14; 95% CI 1.01 1.29). Conclusions Symptoms of nausea, vomiting or poor appetite during pregnancy are associated with LBW, SGA and preterm birth in a setting with limited resources, especially beyond the first trimester. Trial registration Prospectively registered at ClinicalTrials.gov on Dec 17, 2009 (NCT01034254).

scholarly journals Impact of maternal vaccination timing and influenza virus circulation on birth outcomes in rural Nepal

2017 ◽  
Vol 140 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Naoko Kozuki ◽  
Joanne Katz ◽  
Janet A. Englund ◽  
Mark C. Steinhoff ◽  
Subarna K. Khatry ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Birth Outcomes ◽  
Maternal Vaccination ◽  
Rural Nepal

Economic assessment of a women's group intervention to improve birth outcomes in rural Nepal

The Lancet ◽  
2005 ◽  
Vol 366 (9500) ◽  
pp. 1882-1884 ◽  
Author(s):  
Josephine Borghi ◽  
Bidur Thapa ◽  
David Osrin ◽  
Stephen Jan ◽  
Joanna Morrison ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Group Intervention ◽  
Economic Assessment ◽  
Rural Nepal

scholarly journals Impact of Improved Biomass and Liquid Petroleum Gas Stoves on Birth Outcomes in Rural Nepal: Results of 2 Randomized Trials

2020 ◽  
Vol 8 (3) ◽  
pp. 372-382
Author(s):  
Joanne Katz ◽  
James M. Tielsch ◽  
Subarna K. Khatry ◽  
Laxman Shrestha ◽  
Patrick Breysse ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Randomized Trials ◽  
Liquid Petroleum Gas ◽  
Rural Nepal ◽  
Gas Stoves

Prenatal and childhood exposures are associated with thymulin concentrations in young adolescent children in rural Nepal

2019 ◽  
Vol 11 (2) ◽  
pp. 127-135 ◽  
Author(s):  
Amanda C. Palmer ◽  
Kerry J. Schulze ◽  
Subarna K. Khatry ◽  
Keith P. West
Keyword(s):  
Early Life ◽  
Disease Risk ◽  
Geometric Mean ◽  
Positive Association ◽  
Cluster Randomized Trial ◽  
Multivariate Model ◽  
Anthropometric Measures ◽  
Cluster Randomized ◽  
Rural Nepal ◽  
Β Carotene

AbstractThe thymus undergoes a critical period of growth and development early in gestation and, by mid-gestation, immature thymocytes are subject to positive and negative selection. Exposure to undernutrition during these periods may permanently affect phenotype. We measured thymulin concentrations, as a proxy for thymic size and function, in children (n = 290; aged 9–13 years) born to participants in a cluster-randomized trial of maternal vitamin A or β-carotene supplementation in rural Nepal (1994–1997). The geometric mean (95% confidence interval) thymulin concentration was 1.37 ng/ml (1.27, 1.47). A multivariate model of early-life exposures revealed a positive association with gestational age at delivery (β = 0.02; P = 0.05) and higher concentrations among children born to β-carotene-supplemented mothers (β = 0.19; P < 0.05). At ∼9–12 years of age, thymulin was positively associated with all anthropometric measures, with height retained in our multivariate model (β = 0.02; P < 0.001). There was significant seasonal variation: concentrations tended to be lower pre-monsoon (β = −0.13; P = 0.15), during the monsoon (β = −0.22; P = 0.04), and pre-harvest (β = −0.34; P = 0.01), relative to the post-harvest season. All early-life associations, except supplementation, were mediated in part by nutritional status at follow-up. Our findings underscore the known sensitivity of the thymus to nutrition, including potentially lasting effects of early nutritional exposures. The relevance of these findings to later disease risk remains to be explored, particularly given the role of thymulin in the neuroendocrine regulation of inflammation.

scholarly journals Nausea, vomiting and poor appetite during pregnancy and adverse birth outcomes in rural Nepal: an observational cohort study

2020 ◽  
Author(s):  
Amanda Regodón Wallin ◽  
James M Tielsch ◽  
Subarna K Khatry ◽  
Luke C Mullany ◽  
Janet A Englund ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
First Trimester ◽  
Observational Cohort Study ◽  
Limited Resources ◽  
Poor Appetite ◽  
Observational Cohort ◽  
Rural Nepal

Abstract Background Nausea and vomiting are experienced by a majority of pregnant women worldwide. Previous studies have yielded conflicting results regarding their impact on birth outcomes and few studies have examined this relationship in settings with limited resources. We aimed to determine the effect of nausea, vomiting and poor appetite during pregnancy on birth outcomes in rural Nepal.Methods Observational cohort study using data collected in two randomized, community-based trials to assess the effect of influenza immunization during pregnancy on reproductive and respiratory outcomes among pregnant women and their offspring. Pregnant women in Sarlahi District, Nepal were recruited from 2011-2013. Exposure was defined as nausea, vomiting or poor appetite at any point during pregnancy and by trimester; symptoms were recorded monthly throughout pregnancy. Adverse outcomes were low birth weight (LBW), preterm birth and small for gestational age (SGA). Adjusted relative risks (aRR) with 95% CIs is reported from Poisson regressions with robust variance.Results Among 3,623 pregnant women, the cumulative incidence of nausea, vomiting or poor appetite was 49.5% (n=1793) throughout pregnancy and 60.6% (n=731) in the first trimester. Significantly higher aRRs of LBW and SGA were observed among women experiencing symptoms during pregnancy as compared to symptom free women (LBW: aRR 1.20; 95% CI 1.05 1.28; SGA: aRR 1.16; 95% CI 1.05 1.28). Symptoms in the first trimester were not significantly associated with any of the outcomes. In the second trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.17; 95% CI 1.01 1.36; SGA: aRR 1.16; 95% CI 1.05 1.29) and a significantly lower aRR for preterm birth (aRR 0.75; 95% CI 0.59 0.96). In the third trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.20; 95% CI 1.01 1.43; SGA: aRR 1.14; 95% CI 1.01 1.29).Conclusions Symptoms of nausea, vomiting or poor appetite during pregnancy are associated with LBW, SGA and preterm birth in a setting with limited resources, especially beyond the first trimester.Trial registration Prospectively registered at ClinicalTrials.gov on Dec 17, 2009 (NCT01034254)

scholarly journals Nausea, vomiting and poor appetite during pregnancy and adverse birth outcomes in rural Nepal: an observational cohort study

2020 ◽  
Author(s):  
Amanda Regodón Wallin ◽  
James M Tielsch ◽  
Subarna K Khatry ◽  
Luke C Mullany ◽  
Janet A Englund ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
First Trimester ◽  
Observational Cohort Study ◽  
Limited Resources ◽  
Poor Appetite ◽  
Observational Cohort ◽  
Rural Nepal

Abstract Background Nausea and vomiting are experienced by a majority of pregnant women worldwide. Previous studies have yielded conflicting results regarding their impact on birth outcomes and few studies have examined this relationship in settings with limited resources. We aimed to determine the effect of nausea, vomiting and poor appetite during pregnancy on birth outcomes in rural Nepal.Methods Observational cohort study using data collected in two randomized, community-based trials to assess the effect of influenza immunization during pregnancy on reproductive and respiratory outcomes among pregnant women and their offspring. Pregnant women in Sarlahi District, Nepal were recruited from 2011-2013. Exposure was defined as nausea, vomiting or poor appetite at any point during pregnancy and by trimester; symptoms were recorded monthly throughout pregnancy. Adverse outcomes were low birth weight (LBW), preterm birth and small for gestational age (SGA). Adjusted relative risks (aRR) with 95% CIs is reported from Poisson regressions with robust variance.Results Among 3,623 pregnant women, the cumulative incidence of nausea, vomiting or poor appetite was 49.5% (n=1793) throughout pregnancy and 60.6% (n=731) in the first trimester. Significantly higher aRRs of LBW and SGA were observed among women experiencing symptoms during pregnancy as compared to symptom free women (LBW: aRR 1.20; 95% CI 1.05 1.28; SGA: aRR 1.16; 95% CI 1.05 1.28). Symptoms in the first trimester were not significantly associated with any of the outcomes. In the second trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.17; 95% CI 1.01 1.36; SGA: aRR 1.16; 95% CI 1.05 1.29) and a significantly lower aRR for preterm birth (aRR 0.75; 95% CI 0.59 0.96). In the third trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.20; 95% CI 1.01 1.43; SGA: aRR 1.14; 95% CI 1.01 1.29).Conclusions Symptoms of nausea, vomiting or poor appetite during pregnancy are associated with LBW, SGA and preterm birth in a setting with limited resources, especially beyond the first trimester.Trial registration ClinicalTrials.gov number (NCT01034254)

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