Pregnant Women In Bangladesh Research Articles

Investigating the prevalence and associated factors of elevated liver enzymes and dyslipidemia during pregnancy

Liver dysfunctions during pregnancy can either be pregnancy-specific or preexisting in acute or chronic form. Data on the prevalence of abnormal liver functions and dyslipidemia during pregnancy in Bangladesh are scarce since these tests are not typically done in routine prenatal screening. This study aims to investigate the prevalence of elevated liver enzymes and dyslipidemia and associated risk factors in a cohort of pregnant women in Bangladesh. This cross-sectional study included 194 pregnant women participants from different trimesters. A standardized questionnaire was used to collect baseline, demographic, and lifestyle data. Blood samples were collected from each participant to measure biochemical parameters such as liver enzymes (ALT and GGT), lipid profile (TC, TG, HDL-C, and LDL-C), glucose, and creatinine levels in the serum. Logistic regression analysis was applied to identify factors associated with liver dysfunction and lipid profile abnormalities. The average age of the participants was 25 ± 5 years. Overall, the prevalence of preeclampsia was 12.4%. Among participants, 27% had increased ALT levels, most in their third trimester, while 11.8% had elevated GGT levels, mostly in early pregnancy. 83.8% of the study subjects had general dyslipidemia, with the highest prevalence in the second trimester and 5.2% had mixed dyslipidemia. Several factors were significantly associated with ALT elevation, such as preeclampsia, elevated blood pressure, low HDL-C levels, high parity number, having a higher number of children, hypertensive disorders during pregnancy and inadequate knowledge about pregnancy diet. On the other hand, advanced maternal age, high gravidity, and mixed dyslipidemia were associated with elevated GGT levels. Conversely, age, hypertensive disorders during pregnancy, preeclampsia, and diabetes were associated with dyslipidemia. In conclusion, elevated levels of liver enzymes and an abnormal lipid profile are common among pregnant women in Bangladesh. Various factors are linked to abnormal liver enzymes and dyslipidemia in these participants. Monitoring liver function and lipid levels, along with proper prenatal care, can help reduce the risk of maternal and neonatal mortality.

Rural-urban disparity in uptaking skilled antenatal care visits by pregnant women in Bangladesh: Zero and One Inflated Poisson regression model.

Utilization of maternal health care services, specifically, antenatal care services from skilled health providers have been given utmost priority in low- and middle-income countries over years with a view of mitigating complications during pregnancy as well as safeguarding the health and survival of both mother and newborn. However, there is a general tendency of pregnant mothers in Bangladesh of receiving skilled antenatal care (SANC) service once, or even never which refrains us to ensure World Health Organization (WHO) recommended eight plus SANC visits, additionally, to meet Sustainable Development Goal (SDG) number three. The study aims at assessing how the average number of SANC visits taken by the reproductive women in Bangladesh changes over the time in rural and urban areas together with finding out the potential demographic and socio-economic factors associated with SANC visits by addressing possible accumulation of zero and one counts in SANC visits. In this study, data have been retrieved from last four waves of Bangladesh Demographic and Health Surveys ranging from 2011 to 2022 and later combined together to form a pooled dataset. Non-parametric Kruskal-Wallis test has been performed for exploring unadjusted association of covariates with the response and Mann-Whitney U test has been conducted for multiple comparison in case of significant association for a covariate having more than two categories. For checking the existence of concurrent inflation at zero and one in the pooled dataset, partial score test has been performed. Based on the results of score test, Zero and One Inflated Poisson regression model has been fitted to the pooled dataset, where an interaction term between area of residence and survey year has been considered for trend analysis. The study highlights that the rate of mean SANC visits is rapidly rising with time among pregnant women not only from the urban areas but also from the rural areas of Bangladesh. However, the rate of change in uptaking the SANC visits is higher in rural area compared to urban area. It was observed that for a given survey year, the rate of mean SANC visits was higher among women from urban areas compared to that among women from rural areas of Bangladesh. This study provides the evidence of 17.2% extra zero counts and 1.1% extra one counts in the pooled dataset. The study results depict that inequity in SANC services based on area of residence prevails in Bangladesh. However, the gap in the rate of mean SANC visits in rural areas compared to urban areas has gradually reduced over time. Based on the results, the study comes up with some recommendations to facilitate the policy makers in improvising strategies and ensuring sustainable rise in SANC counts as well as WHO recommended positive pregnancy experience in the country to meet SDGs.

Demographic Status and Diet Pattern of Preeclamptic and Healthy Pregnant Women - A Comparative Study

Background: Preeclampsia is a hypertensive disorder affecting 2-8% of pregnancies worldwide and is a major contributor to maternal and fetal morbidity and mortality, especially in low- and middle-income countries like Bangladesh. Preeclampsia is characterized by high blood pressure and proteinuria, and its occurrence is influenced by various demographic and dietary factors. Understanding these influences is critical in resource-limited settings to improve health outcomes for both preeclamptic and healthy pregnant women. Objective: This study aimed to assess and compare the demographic characteristics and dietary patterns of preeclamptic and healthy pregnant women in Bangladesh, with the goal of identifying risk factors associated with preeclampsia. Methodology: This cross-sectional comparative study was conducted over one year, from July 2018 to June 2019, at Rajshahi Medical College in Bangladesh. The study included 100 preeclamptic pregnant women as cases and 100 healthy pregnant women as controls, aged 18-35 years and at 28-32 weeks of gestation. Demographic data, dietary patterns, and serum levels of calcium, magnesium, and uric acid were measured. Statistical analyses, including Chi-square and Unpaired t-tests, were conducted using SPSS, with a significance level set at p < 0.05. Results: Preeclamptic women were significantly older and had higher BMI, systolic, and diastolic blood pressures compared to healthy pregnant women. Dietary analysis revealed that 60% of preeclamptic women had non-balanced diets, compared to only 2% of healthy women, indicating a statistically significant difference. However, there was no significant difference in socioeconomic status and parity between the two groups. Educational attainment was lower among preeclamptic women, with a higher proportion having only primary education compared to controls. Conclusion: The study highlights the impact of demographic and dietary factors on the risk of preeclampsia among pregnant women ...

Association of Serum Vitamin D Level with Symptomatic Urinary Tract Infection in Pregnant Women

Background: Urinary tract infections (UTIs) are the most common bacterial infections during pregnancy. Pregnant women in Bangladesh often suffer from UTIs due to a lack of knowledge regarding proper hygiene practices. Adequate vitamin D levels have the potential to enhance the innate immune response, thereby can reduce susceptibility to bacterial infections. Therefore, vitamin D deficiency in pregnant women could increase the risk of urinary tract infections. Aim: To determine the association between maternal serum vitamin D levels and urinary tract infection in pregnancy. Method: This was a case-control study among purposively selected pregnant women attending the inpatient and outpatient department of Obstetrics and Gynaecology, ICMH, Matuail, Dhaka. A total 80 pregnant women between 18-40 years of age were included in this study at their 6-28 weeks of gestation. Among them 40 women who had urinary tract infection, confirmed by presence of ≥105/HPF pus cell in urine routine microscopic examination and a positive urine culture report, were considered as the cases and the rest of the 40 age and gestational age-matched healthy pregnant women without UTI were enrolled as the controls. Aseptically, 5 mL of venous blood was drawn to measure maternal serum vitamin D levels. Statistical analysis was done using the latest version of analytic software SPSS, where required. Results: Among 40 case respondents, Escherichia coli was found to be the most prevalent (60.0%) cause of UTI, with an average maternal serum vitamin D level of 20.5±11.94 ng/ml among those cases. The overall mean (±SD) vitamin D level was much lower among the cases than the controls, 21.1±11.25 ng/mL and 27.9±9.58 ng/ml, respectively. This difference was found statistically significant p=0.004). Considering vitamin D level of 30 ng/mL as the cut-off value, odd’s ratio calculation showed the mother with serum vitamin D level <30 ng/mL had 3.2 times more risk to develop UTI compared to those ...

Association between dietary calcium and pregnancy induced hypertension

Background: Pregnancy induced hypertension (PIH) is one of the major complications of pregnancy. Inadequate calcium (Ca) intake is considered a public health problem in some vulnerable groups, especially pregnant women. A balanced diet during pregnancy with adequate Ca should be the ideal solution, and to proceed in this direction, evidence is required on the nature and extent of Ca deficiency in the diet of PIH mothers. Objectives: To assess the dietary intake of Ca in PIH (compared to non-PIH) mothers and to explore the factors affecting the intake of those nutrients. Methods: Under an observational case-control design, we recruited 300 Bangladeshi pregnant women in two groups (150 with and 150 without PIH), aged between 20-40 years (from 3 hospitals in Dhaka) at the 3rd trimester of pregnancy. A pre-tested questionnaire was used to collect the data. The first part of the questionnaire was allocated to general socio-demographic and clinical characteristics. Secondly, a food frequency questionnaire was used to estimate individual dietary Ca intake. Results: The dietary Calcium intake [(mg/day), median (range)] was significantly lower [265(111-487)] (p<0.001) in the PIH compared to the non-PIH [350(201-984) ;(p<0.001)] group. On bivariate analysis, the dietary Calcium intakes had a significantly negative correlation with mean blood pressure which was considered an indicator of the severity of PIH (r=-0.276; p<0.001) for Ca. On regression analysis, PIH was found to be significantly associated with a lower intake of Ca (b=-0.009; p<0.001) when the effects of age, family history of HTN and family income were adjusted. Conclusion: Dietary consumption of Calcium during pregnancy is much lower than those recommended in our population, PIH seems to have an association with dietary deficiency of Calcium in pregnant women. Bioresearch Commu. 10(2): 1612-1618, 2024 (July)

Thyroid Function Status and Its Impact on Feto-maternal Outcome in Pregnant Women in Bangladesh: A Hospital-based Cross-sectional Study

Thyroid Function Status and Its Impact on Feto-maternal Outcome in Pregnant Women in Bangladesh: A Hospital-based Cross-sectional Study

Effect of Media Exposure and Related Factors on Antenatal Care Visits Among Pregnant Women in Bangladesh: A Study Based on BDHS 2017-18 Data

Providing antenatal care (ANC) to expectant mothers is the primary method of reducing maternal morbidity and death. The objectives of ANC are to monitor and preserve the health and safety of both the mother and the fetus, identify any pregnancy issues and take appropriate action, address the concerns of the mother, get her ready for delivery, and encourage mothers to adopt healthy habits. The goal of this research is to investigate the determinants associated with Bangladeshi women's ANC. Data were obtained from the BDHS for the 2017–18 year, and 4,920 married women of reproductive age (15–49 years) were selected as participants from 18,895 married women. The data was analyzed using multinomial logistic regression as well as descriptive and inferential statistical methods. The main outcome of this study found that 48.4% of respondents received 4 or more ANC visits. The ANC contacts were correlated with factors such as media exposure, division, maternal age, women's education, husband's education, and wealth index. The primary educated women were 0.312 times (p<0.002) less likely to receive 4 or more ANC, compared to higher educated women, and women who don’t access to media, 0.464 times (p<0.000) less likely to engage in 4 or more ANC visits compared to media access. The results of this investigation demonstrate a substantial correlation between media exposure and ANC visits, as well as a noteworthy rise in appropriate ANC visits among expectant mothers with increased media exposure.

Awareness and Preventive Practice of Iron Deficiency Anemia among Pregnant Women in Bangladesh

Awareness and Preventive Practice of Iron Deficiency Anemia among Pregnant Women in Bangladesh

Multicomponent Behavioural Intervention during Pregnancy to Reduce Home Exposure to Second-Hand Smoke: A Pilot Randomised Controlled Trial in Bangladesh and India.

Pregnant women exposed to second-hand smoke (SHS) are at increased risk of poor birth outcomes. We piloted multicomponent behavioural intervention and trial methods in Bangalore, India, and Comilla, Bangladesh. A pilot individual randomised controlled trial with economic and process evaluation components was conducted. Non-tobacco-using pregnant women exposed to SHS were recruited from clinics and randomly allocated to intervention or control (educational leaflet) arms. The process evaluation captured feedback on the trial methods and intervention components. The economic component piloted a service use questionnaire. The primary outcome was saliva cotinine 3 months post-intervention. Most pregnant women and many husbands engaged with the intervention and rated the components highly, although the cotinine report elicited some anxiety. Forty-eight (Comilla) and fifty-four (Bangalore) women were recruited. The retention at 3 months was 100% (Comilla) and 78% (Bangalore). Primary outcome data were available for 98% (Comilla) and 77% (Bangalore). The multicomponent behavioural intervention was feasible to deliver and was acceptable to the interventionists, pregnant women, and husbands. With the intervention, it was possible to recruit, randomise, and retain pregnant women in Bangladesh and India. The cotinine data will inform sample size calculations for a future definitive trial.

IDF23-0415 Prototype of a Mobile App for Managing Stress Levels and Overall Well-being of GDM Pregnant Women in Bangladesh

IDF23-0415 Prototype of a Mobile App for Managing Stress Levels and Overall Well-being of GDM Pregnant Women in Bangladesh

Machine learning prediction of nutritional status among pregnant women in Bangladesh: Evidence from Bangladesh demographic and health survey 2017-18.

Malnutrition in pregnant women significantly affects both mother and child health. This research aims to identify the best machine learning (ML) techniques for predicting the nutritional status of pregnant women in Bangladesh and detect the most essential features based on the best-performed algorithm. This study used retrospective cross-sectional data from the Bangladeshi Demographic and Health Survey 2017-18. Different feature transformations and machine learning classifiers were applied to find the best transformation and classification model. This investigation found that robust scaling outperformed all feature transformation methods. The result shows that the Random Forest algorithm with robust scaling outperforms all other machine learning algorithms with 74.75% accuracy, 57.91% kappa statistics, 73.36% precision, 73.08% recall, and 73.09% f1 score. In addition, the Random Forest algorithm had the highest precision (76.76%) and f1 score (71.71%) for predicting the underweight class, as well as an expected precision of 82.01% and f1 score of 83.78% for the overweight/obese class when compared to other algorithms with a robust scaling method. The respondent's age, wealth index, region, husband's education level, husband's age, and occupation were crucial features for predicting the nutritional status of pregnant women in Bangladesh. The proposed classifier could help predict the expected outcome and reduce the burden of malnutrition among pregnant women in Bangladesh.

Factors Related to Anemia among Pregnant Women in Bangladesh

Factors Related to Anemia among Pregnant Women in Bangladesh

Acceptability of a balanced energy protein (BEP) supplement for pregnant women in Bangladesh.

Balanced energy protein (BEP) supplementation in pregnancy is recommended in the context of undernutrition for the reduction of small-for-gestational age neonates and stillbirths. To inform an effectiveness trial, we evaluated the acceptability of a packaged, ready-to-eat fortified BEP product among women of reproductive age and their health care providers (HCPs) in rural Bangladesh and explored the feasibility of adhering to daily supplementation. We implemented a formative study using focus groups discussions with women (n = 29) and HCPs (n = 17) to introduce the product and investigate components of acceptability. A "trials of improved practice" activity was conducted in subset of women (n = 16) to evaluate adherence to BEP over a 2-week period, followed by focus group discussions to identify challenges with adherence and strategies employed. Contributors to BEP acceptability included the product's sensory attributes, such as taste, smell and texture; the attractive packaging and informative labelling; and the perceived benefits of use. Participants also identified household and community level factors influencing the adoption of BEP, such as trust in the provider, cultural beliefs on supplement use in pregnancy, and family member tasting and approval. Over the 2-week period, women consumed over 80% of the supplements provided to them and identified strategies for adherence, including visual aids and reminders from family members or providers. HCPs recommended targeted communication messages for mothers-in-law to foster a supportive home environment. Findings informed changes to the BEP product to improve acceptability and shaped the content of communication messages to optimise adherence in a forthcoming effectiveness trial.

Anaemia and Its Determinants among Pregnant Women Attending for Accessing Antenatal Care in Dhaka, Bangladesh

Anaemia is a major cause of maternal mortality in low- and middle-income countries and Bangladesh. The primary objective of this study was to evaluate the prevalence of anemia and its contributing factors among pregnant women in Dhaka, Bangladesh. A total of 260 pregnant women were included in this study, recruited from two healthcare facilities in Dhaka. The primary outcome of interest was the presence or absence of anaemia (yes or no). The exposure variables encompassed various characteristics related to the women, their partners, and the community. To investigate the associations between the outcome and exposure variables, multivariate logistic regression techniques were employed. The findings revealed that two-thirds of the pregnant women in the study were anemic. Notable socio-demographic determinants of anaemia included women aged between 21 and 30 years, unemployment, residing in households with lower wealth, and not taking iron supplements during the current pregnancy. Additionally, a history of previous abortions was identified as a risk factor for anaemia during pregnancy. The prevalence of anaemia among pregnant women in Bangladesh is notably high. There is a pressing need for improvements in the provision of antenatal care and other healthcare services to address this issue effectively.

Disparities, distribution, and determinants in appropriate timely initiation, number, and quality of antenatal care in Bangladesh: Evidence from Demographic and Health Survey 2017-18.

Like many other low- and middle-income countries, Bangladesh experiences a disproportionately higher number of maternal and neonatal deaths compared to high-income countries. Despite this, a majority of pregnant women in Bangladesh do not receive appropriate antenatal care (ANC). We investigated the disparities, distribution, and determinants of the timing, number, and quality of ANC in this country. This cross-sectional study analyzed Bangladesh Demographic and Health Survey (BDHS) 2017-18 data on ever-married reproductive-age (i.e., 15-49-year-olds) women. After describing the study sample and proportions, multilevel logistic regression was applied to study determinants. The prevalence and odds of the studied outcomes were higher among women with higher parity, a higher education level, more highly educated husbands, urban residence, and residence in some administrative divisions (p<0.05). For instance, among women in the poorest, poorer, middle, richer, and richest wealth quintiles, the proportions of those who initiated ANC during the first trimester were 22.2% (95% confidence interval (CI): 19.6-25.0), 30.1% (95% CI: 27.1-33.2), 35.1% (95% CI: 31.7-38.6), 38.5% (95% CI: 35.2-42.0), and 61.0% (95% CI: 57.5-64.3). Then, compared to women in the poorest wealth quintile, the adjusted odds ratio (AOR) for ANC initiation was higher among those in the poorer (AOR: 1.3, 95% CI: 1.1-1.7), middle (AOR: 1.5, 95% CI: 1.2-1.9), richer (AOR: 1.4, 95% CI: 1.1-1.8), and richest (AOR: 2.7, 95% CI: 2.1-3.5) household wealth quintiles. Given the importance of appropriate ANC, it is crucial to increase awareness and coverage among women with low socioeconomic status and rural residence, among other factors studied.

Perceived Health Status and Health Promoting Behaviors among Pregnant Women in Bangladesh

Background: Worldwide, approximately 99% of maternal death occurred in developing countries among 358000 maternal deaths. Perceived health status and health-promoting behaviors are the factors that can increase awareness and decrease the health risk of the mother and child. Nurses have the opportunity to provide information related to healthy lifestyles through health promotion programs to reduce maternal morbidity and mortality. Objective: The purpose of this study is to examine the level of perceived health status and health-promoting behaviors among pregnant women in Bangladesh. Method: A descriptive cross-sectional type of study was conducted among 148 pregnant women by convenience sampling technique with three tertiary level hospitals, in Dhaka. The instrument consisted of three parts: Socio-demographic, perceived health status, and health-promoting behaviors questionnaire. 14 items with a 5-point Likert Scale and 44 items with a 4-point Likert were used respectively. Data were collected through a structured questionnaire with face-to-face interviews. Data were analyzed by a computer software program using T-test, ANOVA, and Pearson product-moment Correlation. Result: The result shows that the mean score of perceived health status (M = 55.99, SD = 10.83), and HPBs (M = 144.78, SD = 14.10). Perceived health status is significantly moderately correlated with HPBs (r = .517, p = .000). Following demographic characteristics are those significantly associated with HPBs; education (F = 6.154, p = .003), monthly family income (r = .422, p = .000), distance from hospital to residence (r = -.172, p= .037), and pregnancy trimester (F = 12.427, p = .000). Conclusion: The study concluded that overall perceived health status and HPBs were at good level of HPBs of the pregnant women. It should be taken into account that perceived health status and socio-demographic characteristics are the influencing factors on the health-promoting behaviors of pregnant women in Bangladesh.

A multilevel analysis to determine the factors affecting WHO recommended quantity antenatal care utilizations of pregnant women in Bangladesh

Antenatal Care utilizations have become an essential phenomenon to all pregnant women as a means of disease preclusion during pregnancy and safe live birth. To lessen maternal death and disease, proper (minimum eight) antenatal care (ANC) contacts are necessary according to World Health Organization (WHO) new guideline. The aim of this study is to assess the factors affecting proper antenatal care utilization of pregnant Bangladeshi women. The study used data from the most recent Bangladesh Demographic and Health Survey 2017–18 for conducting a two-level binary logistic regression model. A weighted sample of 4866 women and 675 clusters were considered as individual and community level respectively. The results exhibited only 11.6% women took proper antenatal care during pregnancy. The study found 23.9% variability in utilizations of Antenatal care belongs to community-level factors. At individual-level, mother’s occupation, body mass index, birth-order, pregnancy intention, education, delivery place, and media access and at community-level, rural communities (AOR = 0.70, 95% C.I = 0.542–0.920), and communities having media access (AOR = 1.38, 95% C.I = 0.979–1.96) had significant relationship with proper antenatal care utilizations of pregnant women. After testing random slopes of individual-level variables, only education of women covariate was found to be varied from community to community. This study suggests that uptake of proper antenatal care depend on both individual and community level covariates and there lies extensive variation among them. Future studies on wider aspect are therefore suggested to determine obstacles in making proper Antenatal care utilizations.

Vitamin D deficiency in pregnancy and the risk of preterm birth: a nested case–control study

BackgroundEach year, an estimated 15 million babies are born preterm. Micronutrient deficiencies, including vitamin D deficiency (VDD), are common in many low- and middle-income countries (LMICs), and these conditions are often associated with adverse pregnancy outcomes. Bangladesh experiences a high prevalence of VDD. The country also has a high preterm birth (PTB) rate. Using data from a population-based pregnancy cohort, we estimated the burden of VDD during pregnancy and its association with PTB.MethodsPregnant women (N = 3,000) were enrolled after ultrasound confirmation of gestational age at 8–19 weeks of gestation. Trained health workers prospectively collected phenotypic and epidemiological data at scheduled home visits. Trained phlebotomists collected maternal blood samples at enrollment and 24 -28 weeks of gestation. Aliquots of serum were stored at -800 C. We conducted a nested case–control study with all PTB (n = 262) and a random sample of term births (n = 668). The outcome, PTB, was defined as live births < 37 weeks of gestation, based on ultrasound. The main exposure was vitamin D concentrations of 24–28 weeks maternal blood samples. The analysis was adjusted for other PTB risk factors. Women were categorized as VDD (lowest quartile of 25(OH)D; < = 30.25 nmol/L) or not deficient (upper-three quartiles of 25(OH)D; > 30.25 nmol/L). We used logistic regression to determine the association of VDD with PTB, adjusting for potential confounders.ResultsThe median and interquartile range of serum 25(OH)D was 38.0 nmol/L; 30.18 to 48.52 (nmol/L). After adjusting for co-variates, VDD was significantly associated with PTB [adjusted odds ratio (aOR) = 1.53, 95% confidence interval (CI) = 1.10 – 2.12]. The risk of PTB was also higher among women who were shorter (aOR = 1.81, 95% CI: 1.27–2.57), primiparous (aOR = 1.55, 95% CI = 1.12 – 2.12), passive smokers (aOR = 1.60, 95% CI = 1.09 – 2.34), and those who received iron supplementation during pregnancy (aOR = 1.66, 95% CI: 1.17, 2.37).ConclusionVDD is common in Bangladeshi pregnant women and is associated with an increased risk of PTB.

Knowledge, Attitudes and Practices of Pregnant Women and Healthcare Providers in Bangladesh regarding Multivitamin Supplements during Pregnancy

Micronutrient deficiencies are widespread among pregnant women in low- and middle-income countries (LMIC) and lead to potentially adverse effects for mother and baby. In Bangladesh, maternal malnutrition remains a severe problem, with high rates of anemia (49.6% of pregnant women and 47.8% of lactating women are anemic) and other nutritional deficiencies. A Knowledge, Attitudes, and Practices (KAP) study was conducted to assess Bangladeshi pregnant women's perceptions and related behaviors, as well as awareness and knowledge among pharmacists and healthcare professionals concerning prenatal multivitamin supplements. This was done in both rural and urban areas across Bangladesh. A total of 732 quantitative interviews were conducted (330 with providers and 402 with pregnant women, with an equal split between urban and rural areas for both sets of audiences; 200 women were users of prenatal multivitamin supplements, while 202 women were aware non-users). The study identified a few findings that can guide further research or market-based interventions to reduce micronutrient deficiencies. These include most pregnant women not knowing the right time to start multivitamin supplements (56.0%, [n = 225], stating that a woman should start taking supplements 'after the first trimester'), not knowing their benefits, and how they help both the mother and baby-only 29.5% [n = 59] stated that they believed the supplements helped their baby to grow well). Further, barriers to taking the supplements include women believing a nutritious diet is a substitute (88.7% [n = 293]), and a perceived lack of support from other family members (21.8%, [n = 72]). This suggests that there is a need for further awareness-raising among all pregnant women, their family members, and providers.

Comparison of Interlukin-10, Tumor Necrosis Factor-α and Complement-3 Levels among Bangladeshi Pregnant Women with or without Hepatitis E Virus Infection

Background: Several plasma proteins are proposed as biomarkers for acute HEV infected patients, but have not been validated among pregnant Bangladeshi women infected with HEV.&#x0D; Objective: In this present study, levels of interlukin-10 (IL-10), tumor necrosis factor α (TNF-α) and complement-3 (C3) were measured among HEV infected pregnant women and were compared with pregnant and HEV infected women.&#x0D; Methodology: This comparative cross-sectional study was conducted among the pregnant women who were admitted to the Department of Medicine, Department of Obstetrics &amp;amp; Gynecology, and Department of Hepatology of Dhaka Medical College Hospital (DMCH) and Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh for 1 year period. The study population included acute HEV infected pregnant women (HEV-P), healthy pregnant women (HPC) and HEV-infected non-pregnant women (HEV-NP) of the same age group. Interlukin-10 (IL-10), Tumor necrosis factor α (TNF-α) and complement 3(C3) levels were quantified by enzyme linked immunosorbent assay (ELISA) and turbidometry, respectively.&#x0D; Result: A total number of 81 women were recruited for this study of which 31 cases were acute HEV infected pregnant women (HEV-P); 25 cases were healthy pregnant women (HPC) and 25 cases were HEV infected non-pregnant women (HEV-NP) of the same age group. The mean levels with SD of the C3 level showed significant difference (P; 0.05) between groups of HEV-P (67.73±38.24 mg/dl), HEV-NP (147.9±22.28 mg/dl) and HPC (182.6±17.49 mg/dl). Though plasma TNF-α did not show any significant change (P; .05) in any of the groups, the IL-10 level was elevated significantly (p; 0.05) in HEV infected pregnant patients (0.187±0.3 ng/ml) then the non-pregnant HEV patients (0.027 + .08 ng/ml) and pregnant women group (0.012±0.04 ng/ml).&#x0D; Conclusion: In conclusion, increased levels of C3 and IL-10 observed in HEV infected pregnant women.&#x0D; Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):157-161