Social support, distress, stress, anxiety, and depression as predictors of suicidal thoughts among selected university students in Bangladesh.

This study examines the association of perceived social support with suicidal thoughts among a young adult sample of university students and estimates the degree to which perceived stress, distress, anxiety, and depression may explain the association. A cross-sectional survey was conducted from June to September 2022 among 642 students, selected using the probability proportional to size procedure, at a large university in Bangladesh. We used the Multidimensional Scale of Perceived Social Support (MSPSS) to measure support. The Impact of Events Scale-Revised (IES-R), the Perceived Stress Scale (PSS-10), the Generalized Anxiety Disorders (GAD-7) scale, and the Patient Health Questionnaire (PHQ-9) were used to assess distress, stress, anxiety, and depression. The association between social support and suicidal thoughts was examined using multivariable logistic regression models. Mediation analyses were carried out using the Karlson, Holm, and Breen (KHB) method. We found that perceived social support was associated with lower odds of suicidal thoughts after controlling for other variables (adjusted odds ratio = 0.94; 95% confidence interval = 0.92-0.96). Mediation analysis showed that, after adjusting for potential confounders, the mediating effects among the total effect of perceived social support on suicidal thoughts were 56.1%, 20.8%, 22.5%, 38.8%, and 50.9% for all mental disorders together and four specific adverse mental health outcomes, i.e., perceived distress, stress, anxiety, and depression, respectively. This study demonstrates that perceived social support reduces the likelihood of suicidal thoughts among university students, and mental disorders have a partial mediating effect on the association. Suicide prevention and mental health promotion efforts among university students should consider encouraging students to build and strengthen a strong social support network.

Continuation of education after marriage and its associated factors among young adult women: findings from the Bangladesh Demographic and Health Survey 2017-2018.

OBJECTIVE: To identify the individual and community-level variables associated with the continuation of education among currently married young adult women in Bangladesh. DESIGN: Cross-sectional data extracted from the Bangladesh Demographic and Health Survey (BDHS), 2017-2018. The BDHS is a stratified cluster sample of households conducted in two and three stages in both rural and urban settings. A multilevel multinomial logistic regression analysis was employed to identify the associated factors. SETTING: Bangladesh. PARTICIPANTS: Currently married young adult women aged 15-29 years (n=4595). PRIMARY OUTCOME: Continuation of education after marriage was measured in the BDHS by asking respondents, 'Did you continue your studies after marriage?' with the response options: no; yes, less than a year; yes, for 1-2 years; yes, for 3-4 years; and yes, for 5+ years. RESULTS: Among young adult women, 28.2% continued education after marriage for different durations of years (<1 year to 5+ years). The odds of continuing education after marriage for <1 year (adjusted OR (aOR): 0.68; 95% CI 0.50 to 0.90), 1-2 years (aOR: 0.67; 95% CI 0.47 to 0.96) and ≥5 years (aOR: 0.38; 95% CI 0.17 to 0.85) were lower among women who justified wife beating compared with women who did justify it. Compared with the high-literate community, women from the low-literate community were less likely to continue education after marriage for <1 year (aOR: 0.53; 95% CI 0.42 to 0.66), 1-2 years (aOR: 0.47; 95% CI 0.36 to 0.61), 3-4 years (aOR: 0.32; 95% CI 0.22 to 0.46), and for ≥5 years (aOR: 0.29; 95% CI 0.17 to 0.48). Several other individual-level and community-level variables, such as age at marriage, first birth interval, partner educational status, household wealth index, community economic status and region, were found to be associated with the continuation of education after marriage for different durations. CONCLUSIONS: The proportion of women continuing their education after marriage in this sample is low. This study provides insight into the individual-level and community-level barriers women encounter in continuing their education after marriage. The identification of these barriers helps policy-makers develop effective intervention programmes to promote women's educational attainment.

Women's Sexual Empowerment and Its Relationship to Contraceptive Use in Bangladesh: Findings From a Recent National Survey.

Objectives: This study aimed to assess the relationship between women's sexual empowerment and contraceptive use among married Bangladeshi women from a nationally representative sample. Methods: Secondary data analysis was conducted using the Bangladesh Demographic and Health Survey (BDHS) 2017-18. The investigation covered a total of 14,515 married, non-pregnant women who were residing with their spouses. Multivariable logistic regression analysis was fitted to assess the relationship between the variables of interest. Results: A unit increase in the sexual empowerment scale increases the odds of contraceptive use by 13%. While increasing age, being Muslim, having a spouse who is older by more than 10 years, and living in rural areas are associated with lower odds of using contraceptives than their respective counterparts, secondary or higher levels of education, having more living children, exposure to TV or radio, and employment are associated with higher odds of using contraceptives. Conclusion: The study's findings point to the need for addressing women's perceptions of their right to sexual and reproductive health and equity in order to further efforts to achieve universal access to reproductive health services.

Mediating role of perceived stress on the association between domestic violence and postpartum depression: cross-sectional study in Bangladesh.

BACKGROUND: Postpartum depression (PPD) is a major depressive disorder developed after childbirth that negatively affects the well-being of both mother and infant. The relationship between domestic violence and the development of PPD symptoms is well documented. However, empirical evidence is lacking on how a person's perception of stress mediates this relationship. AIMS: To estimate the degree to which perceived stress may explain the association between being the victim of domestic violence and developing PPD symptoms among Bangladeshi mothers. METHOD: A cross-sectional survey design was employed from October to December 2019 to collect data from 497 postpartum mothers within the first 6 months of giving birth. The associations between domestic violence victimisation and developing PPD symptoms were assessed using multivariable logistic regressions. The Karlson-Holm-Breen method was used for mediation analysis. RESULTS: One-third (34%) of the mothers in this sample reported experiencing PPD within 6 months. A one-item increase in the number of reported experiences ('items') of controlling behaviour, emotional domestic violence and physical domestic violence increased the odds of developing PPD symptoms by 27%, 40% and 31% respectively, after controlling for other variables and mediators. Furthermore, after adjusting for other variables, the mediating effect of perceived stress on the association of controlling behaviour, emotional domestic violence, physical domestic violence and any form of domestic violence with developing PPD symptoms was 45.1%, 43.0%, 31.2% and 37.5% respectively. CONCLUSIONS: Findings suggest that perceived stress partially mediates the association between domestic violence victimisation and developing PPD symptoms. Understanding these complex relationships may help policymakers to formulate appropriate intervention strategies and support services.

Differential persistence of neutralizing antibody against SARS-CoV-2 in post immunized Bangladeshi population.

Development of effective vaccines have been immensely welcomed by the world to prevent the transmission of SARS-CoV-2. However, the duration and clinical implications of antibody-mediated natural immunity in SARS-CoV-2 have not been adequately elucidated alongside some other immune system transforming factors. In a cohort study, we measured NAb titer following the 2nd immunization dosage of the CoviShield (AZD1222) vaccine. The enzyme-linked immunoassay was used to look for SARS-CoV-2-specific NAb. We measured NAb at 30 days after the 2nd dosage of immunization and > 96% titer was detected in 42.9% of subjects, but only 5.1% of subjects retained the same level after 180 days. The median NAb titer dropped significantly, from 92% at 30 days to 58% at 180 days (p < 0.001). Besides, there were significant differences observed in NAb titer after 180 days by age, sex, COVID-19 infection, tobacco use, and asthma patients. However, SARS-CoV-2 infection along with two dosages of immunization upheld NAb titer (p < 0.001) even at the end of the study period.

Mental health status of informal waste workers during the COVID-19 pandemic in Bangladesh.

The deadliest coronavirus disease 2019 (COVID-19) is taking thousands of lives worldwide and presents an extraordinary challenge to mental resilience. This study assesses mental health status during the COVID-19 pandemic and its associated factors among informal waste workers in Bangladesh. A cross-sectional survey was conducted in June 2020 among 176 informal waste workers selected from nine municipalities and one city corporation in Bangladesh. General Health Questionnaire (GHQ-12) was used to assess respondents' mental health. The study found that 80.6% of the individuals were suffering from psychological distress; 67.6% reported anxiety and depression, 92.6% reported social dysfunction, and 19.9% reported loss of confidence. The likelihood of psychological distress (Risk ratio [RR]: 1.23, 95% confidence interval [CI]: 1.02-1.48) was significantly higher for female than male. Multiple COVID-19 symptoms of the family members (RR: 1.20, 95% CI: 1.03-1.41), unawareness about COVID-19 infected neighbor (RR: 1.21, 95% CI: 1.04-1.41), income reduction (RR: 1.60, 95% CI: 1.06-2.41) and daily household meal reduction (RR: 1.34; 95% CI: 1.03-1.73) were also found to be associated with psychological distress. These identified factors should be considered in policy-making and support programs for the informal waste workers to manage the pandemic situation as well as combating COVID-19 related psychological challenges.

Relationship between maternal healthcare utilisation and empowerment among women in Bangladesh: evidence from a nationally representative cross-sectional study.

OBJECTIVE: To examine the relationship between women's empowerment and maternal healthcare utilisation in Bangladesh. DESIGN: This cross-sectional study uses data from the most recent nationally representative Bangladesh Demographic and Health Survey, 2017-2018. SETTING: Bangladesh. PARTICIPANTS: Married women aged 15-49 years who had a live birth within the 3 years preceding the survey (n=4767). PRIMARY AND SECONDARY OUTCOME MEASURES: Women's empowerment was measured using the recently developed and validated survey-based Women's emPowERment (SWPER) index. The index includes three domains: social independence, decision-making and attitude to violence. Outcomes included utilisation of at least one antenatal care from skilled providers (ANC1), at least four antenatal care visits (≥4 ANC), delivery assisted by a skilled birth attendant (SBA) and a postnatal visit within 2 days of delivery (PNC). Logistic regression analyses were used to assess the identified relationships. RESULTS: Among participants, 83% received ANC1, 46.3% received ≥4 ANC, 51.9% reported SBA and 50.9% sought PNC. Women with high levels of social empowerment relative to those with low levels were more likely to use ANC1 (adjusted OR (AOR) 1.85; 95% CI 1.40 to 2.45), ≥4 ANC (AOR 1.55; 95% CI 1.27 to 1.90), SBA (AOR 2.12; 95% CI 1.71 to 2.62) and PNC (AOR 1.95; 95% CI 1.56 to 2.44). Compared with women with low levels of decision-making empowerment, women with high levels were more likely to use SBA (AOR 1.49; 95% CI 1.21 to 1.83) and PNC (AOR 1.47; 95% CI 1.19 to 1.81). Additionally, significant inequality was observed among women moving from low to high empowerment in all domains of the empowerment index. CONCLUSIONS: Higher empowerment levels were positively associated with maternal healthcare utilisation in Bangladesh. Our findings suggest the need to address women's empowerment in policies aiming to expand health service utilisation.

Correction: Psychosocial and socio-environmental factors associated with adolescents' tobacco and other substance use in Bangladesh.

[This corrects the article DOI: 10.1371/journal.pone.0242872.].

Exposure to domestic violence and the risk of developing depression within 6 months postpartum in Bangladesh.

PURPOSE: Domestic violence (DV) by husbands or in-laws is a recognized problem in many countries and is associated with a wide range of adverse mental health outcomes. However, detailed knowledge on the relationship between DV experience and postpartum depression (PPD) is essential to design appropriate interventions. Therefore, this study assesses the relationship between maternal experience of DV perpetrated by husbands or in-laws and PPD in Bangladesh. METHODS: A cross-sectional survey was conducted from October to December 2019 among 497 mothers within the first 6 months postpartum who attended a health center in Rajshahi City Corporation, Bangladesh. Multivariable logistic regressions were performed to identify the associations after controlling for potential confounders. RESULTS: The prevalence of PPD in this sample was 34% within the first 6 months after birth; 58.6% of mothers reported having experienced any form of DV in their lifetime. Maternal experience of any form of DV (Adjusted Odds Ratio [AOR] = 1.87; 95% confidence interval [CI] = 1.19-2.93) was associated with PPD, as were experiences of any physical DV (AOR = 2.25; 95% CI = 1.40-3.59), emotional DV (AOR = 2.07; 95% CI = 1.34-3.19), and controlling behavior (AOR = 1.69; 95% CI = 1.08-2.66). Additionally, the likelihood of PPD significantly increased among women who experienced more forms of DV. CONCLUSION: DV perpetrated by husband and/or in-laws is highly prevalent and significantly associated with PPD in Bangladesh. Strategies in developing interventions for improving maternal mental health should consider DV perpetrated by either husband or in-laws.

Female Participation in Household Decision Making and the Justification of Wife Beating in Bangladesh.

We examined female participation in household decision making and its association with the justification of wife beating in Bangladesh. We used nationally representative data from the 2014 Bangladesh Demographic and Health Survey. Our sample consisted of currently married women of age 15 to 49 years (n = 16,463). Chi-square tests and multilevel logistic regression models were performed. Approximately 84% of women in the survey were participants in at least one household decision, and 72% reported that wife beating is not justified in any circumstance. Women who reported their participation in at least one type of household decision less frequently reported that wife beating could be justified than those who did not participate in any household decisions (adjusted odds ratio = 1.49; 95% confidence interval = [1.25, 1.78]). In addition to participation in household decision making, other factors including age at first marriage, females' and their husbands' education, religion, parity, contraceptive use, and socioeconomic status were associated with the justification of wife beating. The results indicate that female participation in household decision making is significantly associated with the justification of wife beating in Bangladesh. Further study is needed, but the results suggest that policy makers should consider interventions proven to empower women and lead to increased participation in decision making as methods that may reduce domestic violence against women.

Justification of Wife Beating and Utilization of Antenatal and Delivery Care in Bangladesh.

We examined the association between women's justification of wife beating and their utilization of professional antenatal and delivery care in Bangladesh. We used data which describes a nationally representative sample of currently married women aged 15 to 49 years (n = 3,449). Services from medically trained providers were considered professional antenatal care (ANC) and delivery services. Women's attitudes toward wife beating in five circumstances (if a woman goes out without telling her husband, neglects children, argues with her husband, refuses to have sexual intercourse with her husband, and burns food) were used to describe the justification of wife beating. Chi-square tests and multilevel logistic regression analyses were performed; 74% of the women would not justify wife beating, 65% attended ≥1 ANC visits, 25% attended ≥4 ANC visits, and 44% utilized professional delivery care. Women who would not justify wife beating were more likely to utilize ≥1 ANC visits (adjusted odds ratio [AOR]: 1.89; 95% confidence interval [CI]: [1.26, 2.81]), ≥4 ANC visits (AOR: 1.14; 95% CI: [0.76, 1.71]), and professional delivery care (AOR: 1.93; 95% CI: [1.31, 2.85]). Older age, women's and husband's higher education, lower parity, urban residence (except for ≥1 ANC visits), and higher socioeconomic statuses including divisional differences were significant confounders for increased utilization of both professional ANC and delivery care. In addition, older age at marriage and current unemployment were also associated with increased utilization of delivery care services. This association between women's justification of wife beating and their utilization of professional antenatal and delivery care services has potential implications for maternal and child health policy in Bangladesh where intimate partner violence is commonplace, and societal norms teach women to obey their husbands and accept submissive roles. Public policy should aim to create awareness among women about the negative impact of justifying wife beating, and accepting intimate partner violence on their own and children's health.

Psychosocial and socio-environmental factors associated with adolescents' tobacco and other substance use in Bangladesh.

BACKGROUND: Tobacco, alcohol, and marijuana are the top three substances used by adolescents. The adverse health effects of these three substances are well documented in epidemiological literature, yet little is known about the substance use and associated factors among adolescents in Bangladesh. This study examines the risk factors for tobacco and other substances use among school-going adolescents in Bangladesh. METHODS: We analyzed data from the 2014 Bangladesh Global School-based Student Health Survey (GSHS) of adolescents aged 13-17 years. We used two outcome measures: tobacco use (TU) and other substance use (SU; alcohol and/or marijuana). We examined a set of reported psychosocial and socio-environmental adverse events as risk factors. Logistic regression analyses were used to identify associations. RESULTS: The prevalence of TU and other SU among school-going adolescents was 9.6% and 2.3%, respectively. The likelihood of TU and other SU was higher among adolescents who reported being bullied (TU: adjusted odd ratio [AOR]: 1.93; 95% confidence interval [CI]: 1.24-3.00; and other SU: AOR: 3.43; 95% CI: 1.46-7.99) and having sexual history (TU: AOR: 19.38; 95% CI: 12.43-30.21; and other SU: AOR: 5.34; 95% CI: 2.17-13.29). Moreover, anxiety-related sleep loss was associated with adolescents' TU (AOR: 2.41; 95% CI: 1.02-5.82) whereas the likelihood of other SU (AOR: 3.27; 95% CI: 1.14-9.44) was higher among lonely adolescents. Experience of adverse socio-environmental factors, such as parental substance use (TU: AOR: 7.81; 95% CI: 5.08-12.01), poor monitoring (TU: AOR: 1.96; 95% CI: 1.16-3.31) and poor understanding (TU: AOR: 2.22; 95% CI: 1.36-3.65), and lack of peer support (TU: AOR: 3.13; 95% CI: 1.84-5.31; and other SU: AOR: 2.45; 95% CI: 1.02-5.91), and truancy (other SU: AOR: 4.29; 95% CI: 1.81-10.12) were also positively associated with TU and/or other SU. Additionally, higher odds of tobacco use were observed among adolescents who reported 1 (AOR: 4.36 times; 95% CI: 1.34-14.24), 2 (AOR: 8.69 95% CI: 1.67-28.23), and ≥3 (AOR: 17.46; 95% CI: 6.20-49.23) adverse psychosocial experiences than who did not report any psychosocial events. CONCLUSIONS: Tobacco and other substance use among school-going adolescents are prevalent in Bangladesh. Several psychosocial and socio-environmental events are associated with TU and other SU, which should be incorporated into adolescent substance use and health promotion programs.

Bullying victimization and adverse health behaviors among school-going adolescents in South Asia: Findings from the global school-based student health survey.

BACKGROUND: Bullying among adolescents is a global public health issue and has adverse behavioral and mental health consequences, yet a little is known about the relationship between bullying victimization and adverse health behaviors in adolescence in South Asian countries. METHODS: Data for this cross-sectional analysis were extracted from the global school-based student health survey (GSHS) in Bangladesh (n = 2,989), 2014 and in Nepal (n = 6,529), 2015. Multivariate logistic regression analyses were used to identify the associations between bullying victimization and adverse health behaviors or outcomes: physical violence, sexual history, tobacco use, alcohol use, drug use, suicide ideation, plan, attempt, loneliness, and sleeping difficulty. RESULTS: The prevalence of bullying victimization that occurred for a minimum of 1 day during the 30 days preceding the survey was 24.5% in Bangladesh and 50.9% in Nepal. This study observed significant relationships between bullying victimization and several adverse health behaviors/outcomes. For example, in Bangladesh, the odds of attempted suicide were found to be higher in adolescents that experienced bullying for 1-2 (adjusted odds ratio [AOR]: 2.92; 95% confidence interval [CI]: 1.64-5.19), 3-5 (AOR: 3.55; 95% CI: 1.69), 6-9 (AOR: 5.33; 95% CI: 1.24-22.77), or 10 days or more (AOR: 9.83; 95% CI: 4.17-23.16) during the 30 days preceding the survey than who did not. CONCLUSIONS: Bullying among adolescents in school is common in Bangladesh and Nepal and is associated with several adverse health behaviors. Bullying and its potential health consequences are needed to be addressed in health promotion and programs in these countries.

Suicidal behavior among school-going adolescents in Bangladesh: findings of the global school-based student health survey.

PURPOSE: Suicidal behavior, defined as non-fatal suicidal thoughts and behaviors that include having suicide ideation, plan, and attempts, is a leading cause of injury and death among adolescents globally. This study aimed to explore the prevalence of and the factors associated with suicidal behavior among school-going adolescents in Bangladesh. METHODS: This study utilized data from the 2014 Global School-based Student Health Survey (GSHS), Bangladesh. A sample of (n = 2989) school-going adolescents aged 11-18 years was selected for this study. Risk factors of suicidal behavior were identified using a generalized estimating equation-modified Poison regression approach. RESULTS: The age-adjusted prevalence of suicidal behavior among adolescents in Bangladesh was 11.7%. The result indicated that individual psychosocial factors such as loneliness [adjusted risk ratio (ARR) 1.36; 95% confidence interval (CI) 1.02-1.81], anxiety (ARR 2.01; 95% CI 1.43-2.81), being bullied (ARR 1.88; 95% CI 1.51-2.33), and having no close friends (ARR 2.30; 95% CI 1.77-2.97) were associated with increased likelihood of suicidal behavior. Health-risk behaviors such as ever having sexual intercourse, alcohol and drug abuse, and social-environmental factors, such as rare parental homework check, and lack of peer support were found to be positively associated with adolescents' suicidal behavior. Additionally, a dose-response relationship is observed between the experience of multiple adverse psychosocial factors and suicidal behavior. CONCLUSION: Suicidal behavior is prevalent among school-going adolescents in Bangladesh. This study underscores the importance of early screening and interventions targeted to adolescents at risk, which might reduce the suicide rate among this population in Bangladesh.

Double burden of malnutrition at household level: A comparative study among Bangladesh, Nepal, Pakistan, and Myanmar.

BACKGROUND: The coexistence of overweight mother and stunted child at the same household is a type of Double Burden of Malnutrition at Household Level (DBMHL). This particular public health concern is now emerging at an alarming rate among most of the South Asian and its neighboring lower-and-middle income countries which are going through nutritional transition. This study has examined the prevalence rate and the risk factors of DBMHL along with the socio-economic inequality in DBMHL among Bangladesh, Nepal, Pakistan, and Myanmar. METHODS: Latest Demographic and Health Survey datasets were used in this study. To identify the significant association of DBMHL with socio-demographic characteristics, a multivariate technique named as logistic regression model, and for measuring socio-economic inequalities in DBMHL prevalence, relative index of inequality (RII) and slope index of inequality (SII) were used. RESULTS: The prevalence rates of DBMHL were 4.10% (urban: 5.57%, rural: 3.51%), 1.54% (urban: 1.63%, rural: 1.42%), 3.93% (urban: 5.62%, rural: 3.20%), and 5.54% (urban: 6.16%, rural: 5.33%) respectively in Bangladesh, Nepal, Pakistan, and Myanmar. The risk ratios (RR) obtained from RII for Bangladesh, Nepal, Pakistan and Myanmar were 1.25, 1.25, 1.14, and 1.09, respectively, and ß coefficient from SII were 0.01, 0.004, 0.005, and 0.006 unit respectively. In addition to not breastfeeding [Bangladesh (AOR: 1.55; 95% CI: 1.11-2.15), Myanmar (AOR: 1.74; 95% CI: 1.02-2.95)], respondent's older age (in Bangladesh, Nepal, and Myanmar), child's older age (in Pakistan and Myanmar), and middle and rich groups of wealth-index (in Bangladesh and Pakistan) were strong risk factors for DBMHL. On the other hand, female child [Nepal (AOR: 0.50; 95% CI: 0.26-0.95), Pakistan (AOR: 0.58; 95% CI: 0.41-0.84)], higher education [in Pakistan], respondent not participated in decision making [in Bangladesh and Nepal] and media access [Nepal (AOR: 0.44; 95% CI: 0.20-0.98)] had negative association with DBMHL. CONCLUSION: The DBMHL persists in all selected countries, with a higher prevalence in urban areas than in rural areas. In order to control the higher prevalence of DBMHL in urban areas, respective countries need urgent implementation of multisectoral actions through effective policies and empowering local communities.

The double burden of under- and overnutrition among Bangladeshi women: Socioeconomic and community-level inequalities.

BACKGROUND: The prevalence of overweightness in Bangladesh is increasing, while underweightness also continues to persist. A better understanding of the patterns and socioeconomic risk factors of both conditions, particularly among women, is critical in order to promote the development of interventions to improve maternal health in Bangladesh. This study therefore sought to assess the patterns of under- and overweightness between 2004 and 2014 and to examine the predictors of individual and community-level inequalities of under- and overnutrition in Bangladesh. METHODS: Cross-sectional data of 10, 431, and 16,478 ever-married nonpregnant women aged between 15 and 49 years who did not give birth in the two months preceding the survey were extracted from the 2004 and 2014 Bangladesh Demographic and Health Surveys, respectively. Body mass index was used to measure weight status, and underweightness, at-risk for overweightness, overweightness, and obesity were the main outcome variables. Patterns of nutritional change over time was examined by considering the annual average rate of change. Multilevel multinomial logistic regression and quantile regression were used to identify the inequalities. RESULTS: In 2014, the age-adjusted prevalence values of underweightness, at-risk for overweightness, overweightness, and obesity were 19.7%, 14.9%, 18.1% and 4.0%, respectively. A higher average annual rate of reduction of underweightness was found among wealthier, highly educated, and wealthier community-living women, while a rate of increase of overweightness was found among poorer, uneducated, and poor community-living women. Individual and community-level inequalities of malnutrition were observed among these populations. In comparison with women living in low wealth communities, women from wealthier communities were at an increased risk of being at-risk for overweightness [adjusted odds ratio (AOR): 1.53, 95% confidence interval (CI): 1.23-1.91], overweight (AOR: 1.60, 95% CI: 1.27-2.00), and obese (AOR: 2.12, 95% CI: 1.42-3.18). CONCLUSIONS: This study suggests the coexistence of a double burden of under- and overnutrition in Bangladesh and that the prevalence of overweightness surpasses that of underweightness. The burdens of under- and overnutrition are strongly associated with women's individual socioeconomic positions and the nature of the community in which they live.

Association of secondhand smoke and depressive symptoms in nonsmoking pregnant Women: A systematic review and meta-analysis.

BACKGROUND: Globally about 30% of adult women and 40% of children are exposed to secondhand smoke (SHS) from active smokers. SHS exposure of pregnant women has been associated with postpartum depression. Unexposed women in pregnancy had lower rates of postpartum depression than women exposed to SHS. This systematic review aimed to determine the association of depressive symptoms and exposure to SHS in nonsmoking pregnant women. METHOD: The case-controlled, cross-sectional, and cohort studies with a comparison group were included. Studies including women who had smoking history during pregnancy were excluded. The comprehensive electronic databases, CINAHL, EMBASE, and Medline were searched. RESULT: Of the 2777 records screened, seven studies were included in the review for data extraction. The bias of studies was assessed using the RoBANS. We synthesized two studies that showed depressive symptoms at any time during pregnancy and postpartum significantly increased (ORs = 1.77 [95% CI = 1.12 - 2.79]; p = 0.01; I2 = 28%, 4103 women, two studies), and significantly increased the odds of antenatal suicidal ideation in SHS exposed women (ORs = 1.75 [95% CI = 1.14 - 2.70]; p = 0.01; I2 = 51%, 2670 women, two studies). Lack of studies from counties with the highest smoking rates was a limitation. CONCLUSIONS: SHS exposure during pregnancy showed a significant increase in the odds of depressive symptoms. Furthermore, research is required to clarify to association between SHS and depression.

Association between intimate partner violence during pregnancy and maternal pregnancy complications among recently delivered women in Bangladesh.

Intimate partner violence (IPV), an actual or threatened physical, sexual, or psychological abuse by a current or former partner or spouse, is a common global public health issue. Understanding both the prevalence of IPV during pregnancy and its potential impact on the health of pregnant women is important for the development and implementation of interventions to prevent maternal morbidity and mortality. The purpose of this study was to explore the association between maternal experiences of IPV during pregnancy and pregnancy complications. A health-facility-based cross-sectional study was conducted from July 2015 to April 2016 among 400 randomly selected women who were admitted to the postnatal wards of Rajshahi Medical College Hospital for delivery. Data were collected through face-to-face interviews using a structured questionnaire. Multivariable logistic regressions were performed to assess relationships between variables of interest after controlling for potential confounders. Results indicated that 39.0% of women reported physical IPV and 26.3% of women reported sexual IPV during pregnancy. Additionally, 69.5% of women experienced medical complications (MCs); of this group, 44.3% experienced obstetric complications (OCs) and 79.3% experienced any pregnancy complication (AC) during their last pregnancy. The experience of physical IPV during pregnancy was significantly associated with the experience of MCs (adjusted odds ratio (AOR): 2.05, 95% confidence interval (CI): 1.15-4.01), OCs (AOR: 4.23, 95% CI: 2.01-7.12) and AC (AOR: 5.26, 95% CI: 2.98-10.52). Women who experienced sexual IPV during pregnancy were also at increased risk of suffering from any MC, any OC, and AC. Maternal experience of IPV during pregnancy is positively associated with pregnancy complications. Preventing IPV directed at pregnant women might reduce maternal morbidity and mortality in Bangladesh.

Maternal experience of intimate partner violence and low birth weight of children: A hospital-based study in Bangladesh.

OBJECTIVE: Intimate partner violence (IPV) is the most prevalent form of gender-based violence worldwide. IPV either before or during pregnancy has been documented as a risk factor for the health of the mother and her unborn child. The aim of this study was to examine the relationship between maternal experience of IPV and low birth weight (LBW). STUDY DESIGN: A hospital-based survey was conducted among women in the postnatal wards of a large public hospital at Rajshahi, Bangladesh. Data on socio-economic characteristics, reproductive health characteristics, intimate partner violence, and antenatal, delivery and newborn care were collected from 400 women between July 2015 and April 2016. RESULTS: Results of this study indicated that 43% of women reported experiencing any physical IPV in their lifetime, 35.5% of them experienced sexual IPV, and 32.5% experienced both physical and sexual IPV. Approximately one in every three (29.2%) infants was born with LBW. Physical IPV was associated with an increased risk of having a child with low birth weight (adjusted odds ratio [AOR]: 3.01, 95% CI: 2.35-5.81). The risk of infants born with LBW increased with women's lifetime experience of sexual IPV (AOR: 1.98; 95% CI: 1.23-4.15) and both physical and sexual IPV (AOR: 4.05; 95% CI: 2.79-7.33). CONCLUSION: Maternal lifetime experience of IPV is positively associated with LBW children. Preventing women from the experience of IPV may help improve neonatal and child mortality in Bangladesh.