Table 4.
Secondary outcomes in women at 35-37 weeks of pregnancy
| Outcomes | Group A | Group B | Group C | Group D | Preconception intervention v no preconception intervention (A+B v C+D) | Pregnancy intervention v no pregnancy intervention (A+C v B+D) | Preconception and pregnancy intervention v no preconception and pregnancy intervention (A v D) | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| IRR (98.3% CI) | ARR¶ (%) or MD (98.3% CI) | IRR (98.3% CI) | ARR¶ (%) or MD (98.3% CI) | IRR (98.3% CI) | ARR¶ (%) or MD (98.3% CI) | ||||||||
| RTI based on symptoms, n/total (%)* | 193/1150 (16.8) | 251/1008 (24.9) | 175/964 (18.2) | 230/855 (26.9) | 0.93 (0.79 to 1.10) | −1.44 (−4.97 to 2.10) | 0.66 (0.56 to 0.79) | −8.33 (−11.88 to −4.78) | 0.62 (0.48 to 0.79) | −9.76 (−14.91 to −4.61) | |||
| Hypertension, n/total (%)* | 57/941 (6.1) | 71/829 (8.6) | 55/839 (6.6) | 61/741 (8.2) | 0.94 (0.69 to 1.28) | 0.18 (−2.00 to 2.36) | 0.81 (0.58 to 1.13) | −1.86 (−4.05 to 0.33) | 0.71 (0.44 to 1.14) | −1.70 (−4.88 to 1.48) | |||
| Anaemia status (n=1073, 932, 888, 788 for groups A-D, respectively) | |||||||||||||
| Haemoglobin (g/dL), mean (SD)† | 11.7 (1.3) | 11.2 (1.5) | 11.8 (1.2) | 10.9 (1.7) | — | 0.08 (−0.04 to 0.19) | — | 0.68 (0.56 to 0.80) | — | 0.77 (0.59 to 0.95) | |||
| No anaemia* | 815 (76.0) | 533 (57.2) | 694 (78.2) | 430 (54.6) | 1.01 (0.91 to 1.11) | 0.43 (−6.08 to 6.95) | 1.35 (1.22 to 1.51) | 21.00 (14.60 to 27.39) | 1.38 (1.18 to 1.61) | 21.84 (12.85 to 30.83) | |||
| Mild anaemia* | 174 (16.2) | 217 (23.3) | 140 (15.8) | 158 (20.1) | 1.08 (0.90 to 1.30) | 1.53 (−1.87 to 4.93) | 0.74 (0.61 to 0.91) | −5.67 (−9.10 to −2.23) | 0.82 (0.61 to 1.08) | −3.67 (−8.49 to 1.15) | |||
| Moderate anaemia* | 84 (7.8) | 175 (18.8) | 53 (6.0) | 177 (22.5) | 0.94 (0.76 to 1.17) | −0.90 (−3.79 to 1.99) | 0.36 (0.28 to 0.47) | −13.45 (−16.42 to −10.48) | 0.36 (0.25 to 0.50) | −14.90 (−19.37 to −10.43) | |||
| Severe anaemia* | 0 | 7 (0.8) | 1 (0.1) | 23 (2.9) | 0.26 (0.09 to 0.72) | −0.77 (−1.50 to −0.04) | 0.03 (0 to 0.31) | −1.69 (−2.46 to −0.92) | — | — | |||
| Gestational weight gain, kg‡, mean (SD) | 5.3 (2.6) | 4.7 (2.6) | 5.4 (2.7) | 4.2 (2.5) | — | 0.16 (−0.05 to 0.36) | — | 0.88 (0.68 to 1.08) | — | 1.08 (0.80 to 1.36) | |||
| Gestational weight gain, kg§, mean (SD) | 8.8 (3.4) | 7.7 (3.8) | 9.1 (3.6) | 7.3 (3.6) | — | 0 (−0.28 to 0.29) | — | 1.42 (1.15 to 1.70) | — | 1.48 (1.10 to 1.86) | |||
| Morbidity during pregnancy and child birth (reported in first week after birth) | |||||||||||||
| Antepartum haemorrhage, n/total (%)* | 2/1145 (0.2) | 6/1004 (0.6) | 2/959 (0.2) | 4/856 (0.5) | 1.09 (0.30 to 3.94) | 0.03 (−0.39 to 0.45) | 0.19 (0.04 to 0.77) | −0.35 (−0.81 to 0.12) | 0.22 (0.03 to 1.85) | −0.29 (−0.92 to 0.34) | |||
| Preeclampsia or eclampsia, n/total (%)* | 17/1008 (1.7) | 33/876 (3.8) | 24/894 (2.7) | 35/788 (4.4) | 0.72 (0.45 to 1.14) | −0.67 (−2.05 to 0.72) | 0.55 (0.33 to 0.91) | −1.68 (−3.12 to −0.24) | 0.37 (0.17 to 0.78) | −2.78 (−4.90 to −0.66) | |||
| Postpartum haemorrhage, n/total (%)* | 16/1153 (1.4) | 26/1012 (2.6) | 29/969 (3.0) | 23/859 (2.7) | 0.68 (0.41 to 1.12) | −1.44 (−2.49 to −0.38) | 0.83 (0.49 to 1.41) | −0.38 (−1.68 to 0.92) | 0.47 (0.20 to 1.08) | −1.55 (−3.15 to 0.06) | |||
Data are numbers (%) unless indicated otherwise.
ARR=absolute risk reduction; CI=confidence interval; IRR=incidence rate ratio; MD=mean difference; RTI=reproductive tract infection; SD=standard deviation.
Incidence rate ratio, †mean difference, adjusted for place of birth, family possesses below poverty line card, woman’s height, woman’s body mass index for potential confounder and twins for clustering within the household. Not corrected for multiple outcomes or comparisons. ‡Weight gain between confirmation of pregnancy and 26-28 weeks of gestation (n=1086, 1004, 894, 840 for groups A-D, respectively); §weight gain between confirmation of pregnancy and 35-36 weeks of gestation (n=1117, 977, 934, 832 for groups A-D, respectively). ¶Absolute risk reduction, adjusted for place of birth, family possesses below poverty line card, woman’s height, woman’s body mass index for potential confounder and twins for clustering within the household.
Reproductive tract infection: any symptoms of vaginal discharge, itching, burning, swelling, ulcer in genital region, swelling and pain lower abdomen; hypertension: systolic blood pressure ≥140 mm Hg and diastolic blood pressure ≥90 mm Hg; no anaemia: haemoglobin ≥11g/dL; mild anaemia: haemoglobin 10-10.99 g/dL; moderate anaemia: haemoglobin 7-9.99 g/dL; severe anaemia: haemoglobin <7 g/dL; antepartum haemorrhage: reported excessive bleeding from vagina occurring any time during pregnancy, before delivery that wet her clothes; postpartum haemorrhage: reported excessive bleeding after delivery, with or without loss of consciousness; preeclampsia: measured diastolic blood pressure ≥90 mm Hg or systolic blood pressure ≥140 mm Hg and proteinuria (by dipstick1-4+); eclampsia: preclampsia with convulsions before, during, or after pregnancy.
Group A: preconception, pregnancy and early childhood intervention; group B: only preconception intervention; group C: only pregnancy and early childhood intervention; group D: control. Group A+B v group C+D: effect of preconception interventions: women who received interventions compared with those who did not receive preconception interventions; group A+C v group B+D: effect of pregnancy and early childhood interventions: women who received these interventions compared with those who did not receive these interventions; group A v group D: effect of preconception, pregnancy, and early childhood interventions: women who received interventions in these periods compared with those who received routine care.