Adolescence and risk of violent death during pregnancy in Matlab, B a n g l a d e s h

remains controversial. In this study in Bangladesh, pregnant adolescents had a three-fold increase in mortality from intentional and unintentional injuries compared with girls who were not p r e g n a n t . Research suggests that abuse may be more common than other routinely sought complications of pregnancy. 1 T h e International Classification of Diseases excludes accidental deaths from the definition of maternal death, but the classification of deaths from intentional injuries is more ambiguous and such deaths may or may not be attributed to the pregnancy. Studies on mortality from intentional injuries in pregnant women have led to conflicting findings. Few studies have compared death rates during and outside the period of pregnancy, and the causal relation with pregnancy is commonly established on a case-by-case basis. We examined whether deaths from injuries are more common among pregnant women than women who were not pregnant in a rural area of Bangladesh. A previous study in this area has shown that violent deaths were common among unmarried teenage girls, with illegitimate pregnancies suspected to be an underlying cause. 2 Matlab is a rural area of Bangladesh in which demographic events are recorded prospectively and causes of death ascertained by verbal necropsy. 3 Special studies on maternal mortality have enabled us to collect data on all deaths of women during pregnancy and up to 90 days postpartum. 4 , 5