Open defecation in India connected to adverse pregnancies
New research indicates expectant women who defecate in the more are at a higher possibility to deliver prematurely or give birth to babies with considerably lower weight compared to those using toilets.
670 pregnant women were studied by researchers in Orissa State, eastern India.
Along with its neighboring state, Jharkhand, Orissa records the highest percentage of households in India lacking toilets.
Over half a billion people still defecate in the open in India according to WHO.
Among the tribal and rural women part of the study, close to 60 percent said they did not have access to toilets once questioned during the initial 3 months of pregnancy while 40 percent who lived in households where one was installed, close than half reported they used it rarely or only a couple of times per week.
In the findings of the researchers published in the Journal PLOS Medicine, they made the discovery close to a quarter of the women who were studied suffered from “adverse pregnancy outcome” APO, which commonly included low birth weight and premature births.
Though there were reports of APOs among a couple of women who did in fact use toilets, the researchers said the occurrence could have been the trigger of other factors.
When some of the confounding possible caused were factored in such as poor living conditions and high poverty levels, they discovered open defecation was “significantly associated” with a higher risk of APOs. In most of the Indian villages, it is quite normal for majority of the women to defecate in the open.
One co-author of the paper Pinaki Panigrahi from the University of Nebraska Medical Center, said “Analysis of our data demonstrates that improved sanitation is a critical need during pregnancy”.
Writing the paper, the researchers said, “Our results specifically demonstrate that latrine access alone is not associated with a reduction in the burden of APOs; however, latrine use is”.
“Our model estimated 7-fold higher odds of APOs among pregnant women who had access to a latrine but used it only rarely compared to women who used a latrine often/daily”.
The researchers who included public health experts from London School of Hygiene and Tropical Medicine and the University of Iowa, say the study was the first to come up with evidence that linked poor sanitation to increased APOs risk.
They also added another finding which was important which was that high levels of education are associated with reduced APOs risk, something that in previous studies was also suggested.
Low birth weight and premature births are both linked to the increased risk of different kinds of health problems all the way to adulthood such as depression, diabetes and hypertension.
India records the highest premature births number globally at 3.5 million and it is followed by China which records 1.17 million cases.
The Prime Minister, Narendra Modi has made the improvement of sanitation in the country his top most priority and he wants all homes in the country, by 2019 to be installed with a toilet.