Anaemic heart failure: factors associated with progression from severe morbidity to death among pregnant women in India
NDPH/MT18/08
BAckground
Iron-deficiency anaemia is a major cause of direct and indirect maternal deaths in low-to-middle-income countries (LMICs). Anaemia during pregnancy is defined as haemoglobin level <11g/dl (moderate anaemia 7-9.9g/dl and severe anaemia <7g/dl). Moderate and severe iron deficiency anaemia during pregnancy increases the risk of heart failure, but the relationship between anaemia and heart failure is not well investigated. A recent study in two hospitals in a north-eastern state of India showed that one in 300 pregnant women suffered from anaemic heart failure (incidence 0.3%) and the case fatality was 46%. A case-control study is currently being undertaken through the Maternal and Perinatal Health Research Collaboration, India (MaatHRI https://www.npeu.ox.ac.uk/maathri) in 14 hospitals across India to investigate the risk factors, management and outcomes of anaemic heart failure. Considering the high case-fatality, it is also important to understand the factors that are associated with progression from severe morbidity to death in women with anaemic heart failure in order to improve management and outcomes.
Aim: To identify health systems, clinical characteristics and management, antenatal care and socio-demographic factors that contribute to the death of some women diagnosed with anaemic heart failure and the positive elements that save the lives of others.
RESEARCH EXPERIENCE, RESEARCH METHODS AND TRAINING
The student will be able to gain research experience in:
- Primary data collection and secondary data analysis
- Conducting reviews of maternal death and near-miss cases
- Undertaking research in a LMIC setting (India)
The student will be able to develop skills in the following research methods:
- Quantitative statistical analysis of secondary data from observational studies
- Systematic review and meta-analysis
- Qualitative research methods
- Facility-based and community-based reviews of maternal deaths and near-miss cases
The student will undertake the following skills training for the project:
- Conducting systematic review and meta-analysis
- Advanced epidemiology and statistical methods
- Qualitative research methods
In addition, the student will have access to various training programmes offered by the University for postgraduate students including teaching and personal development.
field work, secondments, industry placements and training
As part of this project, the student will have to undertake field work in India for a period of 6-8 weeks. The student will be part of the MaatHRI project and will therefore have all support required for undertaking the field work.
prospective candidate
This project will be suitable for a student who has either a qualification in epidemiology or in public health, and is interested in working in a LMIC setting. The student should have good quantitative skills and an interest in qualitative research methods.