Suicidal ideation and the prevalence of intimate partner violence against women in rural western China.

This study examined the extent of the association between intimate partner violence (IPV) and suicidal ideation in a rural county in Western China. A sample of 1,771 women participated in the study. The lifetime prevalence of physical assault, psychological aggression, and sexual coercion was 34%, 68%, and 4%, respectively. The preceding-year prevalence of physical assault and psychological aggression was 8% and 32%, respectively. The prevalence of lifetime suicidal ideation was 15.9%, and 3.3% of the women had suicidal ideation during the preceding week. Physical abuse victims were at more than four times greater risk of having suicidal ideation than those who had not suffered physical assault.

Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08.

BACKGROUND: There has been concern about rising rates of caesarean section worldwide. This Article reports the third phase of the WHO global survey, which aimed to estimate the rate of different methods of delivery and to examine the relation between method of delivery and maternal and perinatal outcomes in selected facilities in Africa and Latin America in 2004-05, and in Asia in 2007-08. METHODS: Nine countries participated in the Asia global survey: Cambodia, China, India, Japan, Nepal, Philippines, Sri Lanka, Thailand, and Vietnam. In each country, the capital city and two other regions or provinces were randomly selected. We studied all women admitted for delivery during 3 months in institutions with 6000 or fewer expected deliveries per year and during 2 months in those with more than 6000 deliveries. We gathered data for institutions to obtain a detailed description of the health facility and its resources for obstetric care. We obtained data from women's medical records to summarise obstetric and perinatal events. FINDINGS: We obtained data for 109 101 of 112 152 deliveries reported in 122 recruited facilities (97% coverage), and analysed 107 950 deliveries. The overall rate of caesarean section was 27.3% (n=29 428) and of operative vaginal delivery was 3.2% (n=3465). Risk of maternal mortality and morbidity index (at least one of: maternal mortality, admission to intensive care unit [ICU], blood transfusion, hysterectomy, or internal iliac artery ligation) was increased for operative vaginal delivery (adjusted odds ratio 2.1, 95% CI 1.7-2.6) and all types of caesarean section (antepartum without indication 2.7, 1.4-5.5; antepartum with indication 10.6, 9.3-12.0; intrapartum without indication 14.2, 9.8-20.7; intrapartum with indication 14.5, 13.2-16.0). For breech presentation, caesarean section, either antepartum (0.2, 0.1-0.3) or intrapartum (0.3, 0.2-0.4), was associated with improved perinatal outcomes, but also with increased risk of stay in neonatal ICU (2.0, 1.1-3.6; and 2.1, 1.2-3.7, respectively). INTERPRETATION: To improve maternal and perinatal outcomes, caesarean section should be done only when there is a medical indication. FUNDING: US Agency for International Development (USAID); UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), WHO, Switzerland; Ministry of Health, Labour and Welfare of Japan; Ministry of Public Health, China; and Indian Council of Medical Research.

Time trends and regional differences in maternal mortality in China from 2000 to 2005.

OBJECTIVE: To examine trends and variations in maternal mortality in China between 2000 and 2005. METHODS: We used Poisson regression analysis of data from the Chinese National Maternal and Child Health Routine Reporting System between 2000 and 2005 to identify time trends in the maternal mortality ratio (MMR) by province and region. FINDINGS: The MMR declined by an average of 5% per year (crude relative risk, RR: 0.95; 95% confidence interval, CI: 0.94-0.97). There was no interaction between region and year (P = 0.2311). Mortality declined by 5% per year in the eastern region (crude RR: 0.95; 95% CI: 0.92-0.97), by 5% per year in the central region (crude RR; 0.95; 95% CI: 0.94-0.96), and by 4% per year in the western region (crude RR: 0.96; 95% CI: 0.94-0.98). The absolute difference in MMR between the western and eastern regions declined from 65.4 deaths per 100,000 live births in 2000 to 49.4 per 100,000 live births in 2005. CONCLUSION: China is making good progress towards achieving the fifth Millennium Development Goal, and there is no evidence of a widening gap between better-off and economically more deprived provinces.