Articles

How Can We Accelerate Maternal Vaccination Globally?

New maternal vaccines could reduce infant deaths at and after birth, especially in low- and middle-income countries. Work is underway to prepare for new maternal vaccines globally, and the Maternal Immunization Readiness Network for Africa and Asia will support in-country preparation in several low- and middle-income countries. However, the impact of new maternal vaccines will only be realized with supportive policy recommendations and sufficient financing for the development of maternal immunization platforms.

Impact of maternal smoking and secondhand smoke exposure during singleton pregnancy on placental abruption: analysis of a prospective cohort study (the Japan Environment and Children's Study)

This study aimed to investigate the association and population-attributable fraction (PAF) of maternal smoking and secondhand smoke (SHS) exposure during pregnancy with placental abruption. Findings suggest that maternal smoking and SHS exposure during pregnancy significantly contribute to the risk of placental abruption in Japan. Therefore, preventive interventions and measures to reduce exposure are required to prevent placental abruption.

Pregnancy-Induced Hypertension and Association With Future Autoimmune Diseases

The objective of the study was to explore the associations between hypertensive disorders of pregnancy and the subsequent development of autoimmune diseases. Findings suggest that women with a history of pregnancy-induced hypertension face a higher long-term risk of autoimmune diseases, emphasizing the need for ongoing monitoring and preventive care.

Relationship of perinatal outcomes to the competence and quantity of contact with community health workers

The effectiveness of perinatal home visits by community health workers (CHWs) often diminishes when large regional or national programmes are implemented. To address this gap, the authors aimed to identify which CHW behaviours influence maternal and child outcomes. Findings suggest that the current standards for training and monitoring of paraprofessional home visitors are highly unrealistic. Substantial and ongoing investments are needed for visits to occur consistently over time. However, hiring and selection criteria are likely as important as training and monitoring. CHW programmes must be embedded in organisational contexts that are well functioning and have management and support structures that are operational to ensure their success.

Revitalizing Health Care Ethics

Obstetric and pregnancy-related factors associated with caesarean delivery in Bangladesh: a survey in Rajshahi district

This study aimed to identify emerging obstetric and pregnancy risk factors and maternal outcomes associated with caesarean section (CS) delivery among women in Rajshahi district, Bangladesh. The study found that having a CS increases the risk of maternal complications like an obstetric fistula or postpartum anaemia. Considering these results, it is recommended to urgently introduce carefully evaluated clinical practices to assess if vaginal delivery is possible. Counselling women about the delivery method is important to decrease unnecessary CS in Bangladesh.

Effectiveness of couple-based violence prevention education in reducing intimate partner violence during pregnancy in rural Ethiopia: A cluster randomized controlled trial

The purpose of this trial was to examine the effectiveness of Couple-Based Violence Prevention Education (CBVPE) in reducing intimate partner violence (IPV) during pregnancy in rural Ethiopia. The study found that CBVPE is effective in reducing IPV during pregnancy in the study setting. Scale-up and adaptation to similar settings are recommended.

Temporal changes in hospital readmissions for postpartum hypertension in the US, 2010 to 2019; a serial cross-sectional analysis

In this paper, the authors estimate the trends in the incidence of readmissions for postpartum hypertension within 42 days of delivery discharge in the US, disaggregated by median household income. Findings suggest that the increasing postpartum hypertension readmission burden suggests rising future health risks among mothers and a growing cost burden to the U.S. healthcare system. The higher rate of increase in postpartum hypertension readmissions among people without a history of hypertension calls for blood pressure checking in the postpartum period for all patients regardless of risk status.

Physical Intimate Partner Violence Among Women Experiencing Homelessness Before and During Pregnancy

We assessed differences in the association of physical IPV before and/or during pregnancy with adverse health outcomes between women experiencing homelessness (WEH) and domiciled women. Further research is needed to identify factors that may offer WEH a protective effect against the negative impacts of IPV.

Revising the definition of "demand satisfied for modern methods of family planning:" A cross-sectional study to explore incorporating person-centered constructs of demand, choice, and satisfaction

This study explored construct validity of the widely used indicator for "demand satisfied" by comparing the standard definition to alternative definitions of the indicator highlighting dimensions of women's own perceived demand, choice, and satisfaction. Revising the definition of demand satisfied to reflect the principles of person-centered care offers an opportunity to improve construct validity by ensuring that global measurement efforts align with women's reproductive rights.

Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connec

The objective of this study was to evaluate the impact of Nurse-Family Partnership (NFP), a home-visiting programme, on exploratory maternal outcomes in British Columbia (BC), Canada. Findings suggest that relying on the maternal report, at 24 months postpartum, the NFP group had reduced IPV exposure and increased incomes. Benefits observed in late pregnancy were sustained to study end for psychological distress, but not self-efficacy. Longer-term follow-up is recommended.

Tenofovir and Hepatitis B Virus Transmission During Pregnancy: A Randomized Clinical Trial

The objective was to determine whether initiating tenofovir disoproxil fumarate (TDF) at gestational week 16 combined with HBV vaccinations for infants is noninferior to the standard care of TDF at gestational week 28 combined with HBV vaccinations and HBIG for infants in preventing MTCT in mothers with HBV and high levels of viremia. Among pregnant women with HBV and high levels of viremia, TDF beginning at gestational week 16 combined with HBV vaccination for infants was noninferior to the standard care of TDF beginning at gestational week 28 combined with HBIG and HBV vaccination for infants. These results support beginning TDF at gestational week 16 combined with infant HBV vaccine to prevent MTCT of HBV in geographic areas where HBIG is not available.

Maternal Cannabis Use Disorder and Neonatal Health Outcomes: A Data Linkage Study

This study tested for the potential associations between maternal antenatal cannabis use disorders (CUD) and neonatal health outcomes using large linked administrative data. The study found that maternal antenatal exposure to CUD is associated with a range of adverse neonatal outcomes. This study highlights that targeted interventions focusing on antenatal counselling are recommended to mitigate risks associated with maternal cannabis use.

Association of Severe Maternal Morbidity With Subsequent Birth

The objective of the study was to examine the association between severe maternal morbidity (SMM) in a first birth and the probability of a subsequent birth. The findings suggest that women who experience SMM in their first birth are less likely to have a subsequent birth. Adequate reproductive counseling and enhancing antenatal care are crucial for women with a history of SMM. 

The Role of Baby-Friendly Designated Hospitals in Breastfeeding Initiation Across Racial/Ethnic Groups in Florida

The objective of this study is to evaluate the association between birth at a Baby-Friendly Hospitals (BFH) and the breastfeeding initiation in Florida. Giving birth at a BFH is associated with greater odds of breastfeeding initiation. However, when considering the race and ethnicity of mothers, these odds significantly decline, indicating a need to further explore the barriers that may preclude non-Hispanic Black and Hispanic moms from receiving the same benefits of BFH.

Mothers' and fathers' experiences of breastfeeding and returning to paid work after birth: A mixed-method study

The major finding of this study is that breastfeeding is insufficiently recognised as an integral part of the return-to-work process for both parents, generating a form of work-family breastfeeding conflict, where work (part-time or full-time) interferes with family responsibilities and breastfeeding. Family-friendly breastfeeding policies based on equity principles are needed to address workplace gender inequality and discrimination and better support parents in combining work and breastfeeding.

Randomized Trial of Very Early Medication Abortion

This study is a a multicenter, noninferiority, randomized, controlled trial involving women requesting medication abortion at up to 42 days of gestation with an unconfirmed intrauterine pregnancy on ultrasound examination (visualized as an empty cavity or a sac-like structure without a yolk sac or embryonic pole). Findings sugget that medication abortion before confirmed intrauterine pregnancy was noninferior to standard, delayed treatment with respect to complete abortion.

Risk of adverse infant outcomes associated with maternal mental health and substance use disorders

This study aimed to evaluate the association of mental health and substance use disorders on the risk of adverse infant outcomes overall and by race/ethnicity and payer. Given the risk of adverse infant outcomes associated with mental health and substance use disorders across racial/ethnic groups and payers, our findings highlight the critical importance of policies and clinical guidelines that support early identification and treatment of a broad spectrum of mental health and substance use disorders throughout the perinatal period.

Differences in Factors Associated With Preterm and Term Stillbirth: A Secondary Cohort Analysis of the DESiGN Trial

The objective of this study was to identify whether maternal and pregnancy characteristics associated with stillbirth differ between preterm and term stillbirth. Findings suggest that the differences in association exist between mothers experiencing preterm and term stillbirth. These differences could contribute to design of timely surveillance and interventions to further mitigate the risk of stillbirth.

Emergency Maternal Hospital Readmissions in the Postnatal Period: A Population-Based Cohort Stu

The objective of the study was to determine the change in English emergency postnatal maternal readmissions 2007-2017 (pre-COVID-19) and the association with maternal demographics, obstetric risk factors and postnatal length of stay (LOS). Findings suggest that the concerning rise in emergency maternal readmissions should be addressed from a health inequalities perspective focusing on women from minoritised ethnic groups; those <20 and ≥40 years old; primiparous women; and those with specified obstetric risk factors.