Risk of death following pregnancy in rural Nepal

Elizabeth Kimbrough Pradhan, Keith P. West, Joanne Katz, Parul Christian, Subarna Khatry, Steven C. LeClerq, Sanu Maiya Dali, Sharada Ram Shrestha

Research output: Contribution to journalArticlepeer-review


Objective: To investigate the length of time following pregnancy during which the risk of mortality was elevated among women in rural Nepal. Methods: An analysis was performed of prospective data on women participating in the control group of a large, population-based trial. Weekly visits were made for three years to 14 805 women aged 14-45 years. Pregnancy and vital status were assessed. A total of 7325 pregnancies were followed. Mortality during and following pregnancy, expressed on a person-time basis, was compared to referent mortality unrelated to pregnancy (>52 weeks after pregnancy) in the same cohort. Findings: The relative risk (RR) of death during pregnancy but before the onset of labour was 0.93 (95% confidence interval (Cl): 0.38-2.32). During the perinatal period, defined as lasting from the onset of labour until seven days after outcome, the RR of death was 37.02 (95% Cl: 15.03-90.92). The RR for 2 to 6 weeks, 7 to 12 weeks, and 13 to 52 weeks after pregnancy were 4.82, 2.59 and 1.01 with 95% Cl of 1.77-13.07, 0.81-8.26 and 0.40-2.53, respectively. The RR of death was 2.21 (95% Cl. 1.03-4.71) during the conventional maternal mortality period (pregnancy until 6 weeks after outcome). It was 2.26 (95% Cl: 1.05-4.90) when the period was extended to 12 weeks after pregnancy outcome. Conclusion: The risk of mortality associated with pregnancy should be assessed over the first 12 weeks following outcome instead of over the first 6 weeks.

Original languageEnglish (US)
Pages (from-to)887-891
Number of pages5
JournalBulletin of the World Health Organization
Issue number11
StatePublished - Dec 14 2002


  • Cohort studies
  • Maternal mortality
  • Nepal
  • Pregnancy complications/mortality/etiology
  • Prospective studies
  • Puerperium
  • Risk factors

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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