Nabidul Haque Chowdhury

Optimal child development across cognitive, language, and motor domains is essential for long-term health and well-being. Postpartum depression has been linked to adverse child developmental outcomes, but evidence on the impact of persistent postpartum depressive symptoms (PPDS) across these domains and over time remains limited, particularly in low- and middle-income countries. We retrieved data from the Alliance for Maternal and Newborn Health Improvement cohort, collected from 2017 to 2018. Our analysis included 799 mother-child pairs from Sylhet, Bangladesh. We assessed maternal depressive symptoms at 42–60 days and 12 months postpartum using the Patient Health Questionnaire – 9, and child development outcomes at 24 months using the Bayley Scales of Infant and Toddler Development, Third Edition. We used multivariable linear regression models to examine associations between PPDS (depression at both visits) and developmental outcomes in the cognitive, language, and motor domains in children. Adjusted regression analyses showed that, compared to women with no depression, women with PPDS had significantly lower Bayle’s standardised scores in cognitive (−2.06; 95% confidence interval (CI) = −3.60, −0.52) and language domains (−3.13; 95% CI = −5.01, −1.25). We found no statistically significant difference in motor domain scores. We found that PPDS were associated with lower developmental scores in cognitive and language domains among children at 24 months in rural Bangladesh.

Background: Low birth weight (LBW, < 2500 gm) is a major contributor to infant morbidity and mortality and is strongly linked to childhood developmental delays. Methods: To estimate the prevalence of LBW and identify its risk factors, we analyzed data from a community-based prospective cohort study titled, “Aetiology of Neonatal Infections in South Asia”. In Bangladesh, the study was conducted in two sub-districts of Sylhet district. The study followed 24,271 pregnant women from 2011 to 2013. The final analysis included 17,643 singleton live-born babies with available birthweight data. To identify risk factors of LBW, we calculated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) using multivariable modified Poisson regression with robust variance. Results: The prevalence of LBW was 27.61% (95% CI: 26.96–28.28). Maternal factors included undernutrition (MUAC < 22 cm) [aRR 1.19 (95% CI:1.13–1.25)], tobacco use [aRR 1.16 (95% CI: 1.09–1.23)], no antenatal visits with skilled providers [aRR 1.16 (95% CI: 1.07–1.25)], lack of tetanus toxoid vaccination [aRR 1.17 (95% CI:1.11–1.25)], absence of antenatal iron use [aRR 1.10 (95% CI:1.02–1.19)], and pregnancy complications [aRR 1.12 (95% CI:1.05–1.19)]. Other significant factors were lowest household quintile [aRR 1.45 (95% CI: 1.32–1.59)], female sex and residence ≥ 15 km from sub-district hospitals. Conclusions: The burden of LBW was high in rural Bangladesh. Multiple modifiable maternal factors, including undernutrition, tobacco use, lack of tetanus toxoid vaccination, absence of antenatal iron use and no antenatal care, were associated with increased risk of LBW. Maternal and child health programs should prioritize interventions to address these factors.

The online version contains supplementary material available at 10.1007/s44337-026-00595-8.

Pregnancy complications such as preeclampsia (PE) and adverse pregnancy outcomes (APOs) such as preterm birth (PTB), small for gestational age (SGA), and stillbirth (SB) pose a serious global health challenge and collectively contribute to high rates of maternal and infant mortality and morbidity. Close to 2 million stillbirths were reported in 2020 [1,2] while […]

Anaemia during pregnancy poses a major public health problem globally, with reported prevalences ranging from approximately 5.2% to 65.7%. A significant portion of this burden is borne by low- and middle-income countries. We aimed to determine the prevalence of anaemia during pregnancy and identify the factors associated with anaemia in the third trimester of pregnancy in a cohort of women in the rural Sylhet district, Bangladesh. We enrolled 3000 pregnant women between 8 and 19 weeks of gestational age (GA). Trained community health workers collected data on their sociodemographic, obstetric, nutritional, dietary, anthropometric, and household characteristics. Blood samples were collected at baseline (<20 weeks of gestation) and at a follow-up visit between 24-36 weeks of GA to measure haemoglobin (Hb) concentrations. We classified them according to their anaemia status into no anaemia (Hb ≥11g/dl), mild (10 to <11 g/dl), and moderate to severe (<10g/dl) groups. We then used unadjusted and adjusted multinomial logistic regression models to calculate the relative risk ratios (RRR) and 95% confidence intervals (CIs) of potential risk factors for mild or moderate to severe anaemia in the third trimester of pregnancy. Of the 2679 women tested at enrolment, 1010 (38%) were anaemic, 634 (24%) had mild anaemia, and 376 (14%) had moderate to severe anaemia. At the third-trimester follow-up, 1950 (79%) of 2473 women were anaemic; 739 (30%) had mild anaemia, and 1211 (49%) had moderate to severe anaemia. Women with baseline mild anaemia had about a five-fold higher risk (RRR = 4.84; 95% CI = 3.64-6.46) and those with moderate to severe anaemia about an 11-fold higher risk (RRR = 10.78; 95% CI = 6.69-17.35) of having moderate to severe anaemia in the third trimester. Iron supplementation during pregnancy (RRR = 0.75; 95% CI = 0.60-0.93) and drinking tubewell water (RRR = 0.76; 95% CI = 0.60-0.96) were significantly associated with a lower risk of moderate to severe anaemia in the third trimester. We documented a high rate of anaemia in our sample, particularly during the third trimester of pregnancy, underscoring an urgent need for interventions to improve maternal and child health outcomes, such as improved nutrition education, expanded access to and adherence with iron supplementation, and enhanced antenatal care.

The World Health Organization’s Integrated Management of Childhood Illness guidelines emphasise respiratory rate (RR) counting for diagnosing childho

This dataset was generated as part of a study aimed at developing a video expert panel (VEP) to serve as a reference standard for respiratory rate assessme

Introduction: Inappropriate healthcare practices are major contributors to poor outcomes of maternal and pediatric patients. Where resources are scarce, provider-level targeted interventions, such as implementation of standardized, evidence-based protocols and quality improvement initiatives are particularly needed to address these gaps in care. Simulation-based tools have been shown to have a promising effect on improving clinical care management. This study aims to evaluate the effectiveness of a simulation-based platform called E-Patient Quality Improvement and Standardization (EQIS) in improving maternal and pediatric health care in Bangladesh. Methods and analysis: The study employs a prospective, open-cohort design and will be conducted across five tertiary-level hospitals in Dhaka, Bangladesh. All physicians engaged in providing maternal or pediatric care will be recruited. The EQIS platform will facilitate the development of online simulated cases, aiming to enhance physician practice and patient outcomes through involvement and immediate personalized feedback. The development of cases will consist of several stages of review by expert clinicians, ensuring that the cases align with national and local practice guidelines. Each participant physician will work on three cases per round, completing one of six rounds every four months for two years. Data will be collected and analyzed after each round. Descriptive and inferential analysis will be done to assess trends in clinical performance and pinpoint areas for improvement. In addition, patient-level pre- and post-impact data will be collected. These data will evaluate the impact of the EQIS platform on physician performance, as measured by changes in patient satisfaction, treatment costs, referrals, and facility utilization.

Background: According to the World Health Organization’s Integrated Management of Childhood Illness (IMCI) guidelines, childhood pneumonia diagnosis relies on counting respiratory rate (RR). Counting RR by health workers is frequently inaccurate, leading to misdiagnosis and poor outcomes. Automated RR counters could potentially overcome these limitations. To address this gap, we introduced an automated RR counter and developed a reference video expert panel (VEP) to evaluate its performance. Methods: We conducted a cross-sectional study involving children aged 0–59 months with suspected pneumonia in Bangladesh. The RR of children was counted using an automated counter (ChARM) and chest movements were simultaneously videotaped. These videos were interpreted by the VEP, trained to a standard procedure. We assessed ChARM’s accuracy in comparison to the RR generated by the VEP and summarised the time taken to count RR by ChARM. Results: Among 339 enrolled children, ChARM successfully counted the RR of 294 children (86.7%). The VEP reached a consensus (i.e., RR count difference within two breaths per minute (bpm) between two VEP members) in 257 of the 294 children (87.4%). ChARM and the VEP agreed on RR counts within two bpm in 68.1% of children (n = 175/257), with a mean difference of 1.7 bpm and limits of agreement ranging from -6.7 to 10.2 bpm. ChARM classified age-adjusted fast and normal breathing with a sensitivity of 95.8% (95% CI: 88.1–99.1) and a specificity of 93.5% (95% CI: 89.0–96.6), demonstrating high agreement (kappa = 0.86). The median time to count the RR by ChARM was 66 s (interquartile range: 61–73 s). Conclusions: ChARM counted RR accurately against a VEP reference, indicating a potential role in supporting health workers to diagnose pneumonia. However, it was unsuccessful for 1 in 8 cases, typically those more clinically challenging, suggesting a possible systematic bias. Further research is needed to address these issues and confirm ChARM’s reliability for broader use in real-world settings. Trial registration: Current Controlled Trials ISRCTN14120515, registered retrospectively on 19 September 2024.