Article

Estimating the Burden of Maternal and Neonatal Deaths Associated With Jaundice in Bangladesh: Possible Role of Hepatitis E Infection.

Emily S. Gurley, Amal K. Halder, Peter K. Streatfield, Hossain M. S. Sazzad, Tarique M. Nurul Huda, M. Jahangir Hossain, and Stephen P. Luby are with the International Centre for Diarrheal Diseases Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh. Steven P. Luby is also with Centers for Disease Control and Prevention (CDC), Atlanta, GA.
American Journal of Public Health (Impact Factor: 3.93). 10/2012; DOI: 10.2105/AJPH.2012.300749
Source: PubMed

ABSTRACT Objectives. 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. (Am J Public Health. Published online ahead of print October 18, 2012: e1-e7. doi:10.2105/AJPH.2012.300749).

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