{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:24:49Z","timestamp":1790360689452,"version":"4.1.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T00:00:00Z","timestamp":1547424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23-AI103105"],"award-info":[{"award-number":["K23-AI103105"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["50274"],"award-info":[{"award-number":["50274"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Washington Medicine Residency Research Elective"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Adverse birth outcomes, including low birthweight, small for gestational age (SGA), and preterm birth, contribute to 60%\u201380% of infant mortality worldwide. Little published data exist on the association between diarrhea during pregnancy and adverse birth outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were used from 2 community-based, prospective randomized trials of maternal influenza immunization during pregnancy conducted in rural Nepal from 2011 to 2014. Diarrheal illnesses were identified through longitudinal household-based weekly symptom surveillance. Diarrhea episodes were defined as at least 3 watery bowel movements per day for 1 or more days with 7 diarrhea-free days between episodes. The Poisson and log-binomial regression were performed to evaluate baseline characteristics and association between diarrhea during pregnancy and adverse birth outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 527 of 3693 women in the study (14.3%) experienced diarrhea during pregnancy. Women with diarrhea had a median of 1 episode of diarrhea (interquartile range [IQR], 1\u20132 episodes) and 2 cumulative days of diarrhea (IQR, 1\u20133 days). Of women with diarrhea, 85 (16.1%) sought medical care. In crude and adjusted analyses, women with diarrhea during pregnancy were more likely to have SGA infants (42.6% vs 36.8%; adjusted risk ratio = 1.20; 95% confidence interval, 1.06\u20131.36; P = .005). Birthweight and preterm birth incidence did not substantially differ between women with diarrhea during pregnancy and those without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Diarrheal illness during pregnancy was associated with a higher risk of SGA infants in this rural South Asian population. Interventions to reduce the burden of diarrheal illness during pregnancy may have an impact on SGA births in resource-limited settings.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ofid\/ofz011","type":"journal-article","created":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T06:28:10Z","timestamp":1547447290000},"source":"Crossref","is-referenced-by-count":8,"title":["Effect of Diarrheal Illness During Pregnancy on Adverse Birth Outcomes in Nepal"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8279-1111","authenticated-orcid":false,"given":"Kira L","family":"Newman","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Gustafson","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet A","family":"Englund","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle"},{"name":"Center for Clinical and Translational Research, Seattle Children\u2019s Research Institute, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Magaret","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subarna","family":"Khatry","sequence":"additional","affiliation":[{"name":"Nepal Neonatal Intervention Project-Sarlahi, Nepal"},{"name":"Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C","family":"LeClerq","sequence":"additional","affiliation":[{"name":"Nepal Neonatal Intervention Project-Sarlahi, Nepal"},{"name":"Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M","family":"Tielsch","sequence":"additional","affiliation":[{"name":"Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen Y","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, 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