“Too” Much Maternal Mortality: The Effects of Reproductive Patterns in Matlab, Bangladesh

Mizanur Rahman, MEASURE Evaluation

We investigate the association between maternal mortality and reproductive patterns using longitudinal data on nearly 215,000 pregnancy outcomes that occurred during 1978-2008 from the Matlab Demographic Surveillance System. Among the four “too’s” that are commonly believed to increase maternal mortality risk – too young, too short (an interval), too many (children), and too old -- only too old is found to be a significant risk factor. Women in their 20s have the lowest risk of maternal mortality, which then increases with age after 35. First pregnancies have 2.00 times the risk of second or higher order pregnancies. We find evidence of an additional “too” -- too long; interpregnancy intervals of 75 months or longer have 1.52 times higher maternal mortality risk than those with intervals of 27-50 months. Additional risk factors include a history of pregnancy loss(es) and of child death(s), and index outcomes of induced abortion, miscarriage, and stillbirth.