Poor sanitation practices, such as open defecation, are affecting pregnancy outcomes of Indian women, especially premature birth, says a study.
The research, published in the journal PLOS Medicine, studied pregnancy outcomes in two rural areas of Odisha.
Bijaya K. Padhi from the Asian Institute of Public Health, Bhubaneswar, and colleagues enrolled 670 women during the first trimester of their pregnancy, recorded information about toilet access and sanitation practices for each woman at enrollment, and followed them through pregnancy until birth.
They found that compared with women who used a latrine, women who defecated in the open had a significantly greater risk of adverse pregnancy outcomes overall and preterm birth, but not low birth weight.
Although the researchers adjusted for numerous confounding factors in their analysis, including poverty, social class, and caste, the women who defecated in the open may have shared other unknown characteristics that were actually responsible for their increased risk of an adverse pregnancy outcome.
"This study indicates that in the context of maternal and child health prevention research, sanitation is an important dimension of women's health and distinct from social class and caste," said senior study author Pinaki Panigrahi from the University of Nebraska in the US.