Articles

Perinatal mortality rate and adverse perinatal outcomes presumably attributable to placental dysfunction in (near) term gestation: A nationwide 5-year cohort study

This study aimed to evaluate, among (near) term births, the burden of hypoxia-related adverse perinatal outcomes reflected in an association with birth weight centiles as a proxy for placental function. This study aimed to evaluate, among (near) term births, the burden of hypoxia-related adverse perinatal outcomes reflected in an association with birth weight centiles as a proxy for placental function.

The influence of acculturation on the risk of preterm birth and low birthweight in migrant women residing in Western Australia

The authors aimed to study the influence of acculturation on the risk of these outcomes in Australia. Findings suggest that acculturation is an important factor to consider when providing antenatal care to prevent PTB and LBW in migrants. Acculturation may reduce the risk of term-LBW but, conversely, may increase the risk of spontaneous PTB in migrant women residing in Western Australia. However, the effect may vary by ethnicity and warrants further investigation to fully understand the processes involved.

The impact of the Covid-19 pandemic on postnatal depression: analysis of three population-based national maternity surveys in England (2014–2020)

This analysis indicates that Covid-19 had an important negative impact on postnatal women's mental health and may have accelerated an existing trend of increasing prevalence of postnatal depression. Risk factors for postnatal depression were consistent before and during the pandemic. Timely identification, intervention and follow-up are key to supporting women at risk, and it is essential that mechanisms to support women are strengthened during times of heightened risk such as the pandemic.

Factors associated with receipt of adequate antenatal care among women in Rwanda: A secondary analysis of the 2019-20 Rwanda Demographic and Health Survey

The study aimed to determine the factors associated with the receipt of adequate ANC among pregnant women in Rwanda. Findings suggest that the prevalence of women who receive adequate ANC remains low in Rwanda. Effective interventions to increase access and utilization of adequate ANC are urgently needed to further improve the country's maternal and child health outcomes. 

Disparities in who is asked about their perinatal mental health: an analysis of cross-sectional data from consecutive national maternity surveys

The aim of this study was to assess the proportions of women who reported being asked about their mental health during the perinatal period across consecutive national maternity surveys (NMS) in England and to evaluate sociodemographic disparities in who was asked. Despite the UK National Institute for Health and Care Excellence (NICE) recommendations, many women are still not asked about their mental health during the perinatal period, particularly after giving birth. Women from ethnic minority backgrounds are less likely to be asked and these disparities have persisted over time.

Can allostatic load in pregnancy explain the association between race and subsequent cardiovascular disease risk: A cohort study

The objective of the study was to assess the relationship between allostatic load, a measure of cumulative chronic stress in early pregnancy and cardiovascular disease risk, 2-7 years postpartum, and pathways contributing to racial disparities in cardiovascular disease risk. Findings suggest that high allostatic load during pregnancy is associated with cardiovascular disease risk. The relationships between stress, subsequent cardiovascular risk and race warrant further study.

Breastfeeding after return to work: An Australian national workplace survey

This cross-sectional online survey is the first Australian study to explore women's experience of maintaining breastfeeding after return to work, in all work sectors. This study reveals that supportive workplace environments can lead to increased confidence in maintaining milk supply, extending durations of breastfeeding. Women who are confident in their rights to express breastmilk, or breastfeed at work, are more likely to meet their own breastfeeding goals. Education, and awareness raising, on the rights of breastfeeding women in the workplace, is a gender equity imperative that can improve experiences for breastfeeding women, and, increase manager and co-worker knowledge for creating enabling workplace environments for breastfeeding employees.

Stillbirths and neonatal mortality in LMICs: A community-based mother-infant cohort study

The authors aimed to provide reliable estimates of the incidence of stillbirth and neonatal death in three LMICs (Madagascar, Cambodia and Senegal) and to identify their main causes and associated risk factors. These findings underscore the immediate need to improve care for and monitoring of children at birth and during early life to decrease infant mortality. Surveillance of stillbirth and neonatal mortality and their causes should be improved to mitigate this burden in LMICs.

Disrespect and abuse in maternity care in a low-resource setting in Tanzania: Provider's perspectives of practice

This study used a descriptive qualitative design to obtain thick and rich data on disrespect and abuse in maternity care in a low-resource setting in Tanzania. The actions of disrespect and abuse are alarming in practice and are associated with ignorance of fundamental human rights by both providers and recipients of services. Conducting workshops seems a useful approach to revealing disrespect and abuse deep-rooted in practice and provides an opportunity to rectify the problem with providers. A more extensive interventional study will be crucial to address the widespread actions of disrespect and abuse.

Subsequent pregnancy after stillbirth: a qualitative narrative analysis of Canadian families' experiences

This study explores the lived experiences and the most important aspects of person-centred care for Canadian families experiencing a pregnancy after a stillbirth. Participants' responses identified that pregnancy after stillbirth is an extremely stressful time requiring patient-oriented care and support, both physically and psychologically. Families were able to articulate specific areas that would have improved the experience of their subsequent pregnancy. Parents asked for high-quality clinical and psychosocial prenatal care that was specific to them having experienced a prior stillbirth. They also requested connections to others experiencing this similar scenario. Further research is needed to delineate what supports and resources would be needed to ensure this care would be available to all families experiencing pregnancy after stillbirth across Canada and their caregivers.

Maternal health policy environment and the relationship with service utilization in low- and middle-income countries

In this study, the authors aimed to describe the maternal health policy environment and examines its relationship with maternal health service utilization in low- and middle-income countries (LMICs). Findings suggest that despite the availability of supportive structures and free maternity service access policies, there is a dire need for stronger policy support for clinical guidelines and practice regulations, as well as national reporting and review systems for maternal health. A more favorable policy environment for maternal health can improve adoption of evidence-based interventions and increase utilization of maternal health services in LMICs.

Association of Conditional Cash Transfers With Maternal Mortality Using the 100 Million Brazilian Cohort

The objective of this study was to evaluate the association between being a Bolsa Família program (BFP) beneficiary and maternal mortality and to examine how this association differs by duration of BFP receipt, maternal race, living in rural or urban areas, the Municipal Human Development Index (MHDI), and municipal primary health care coverage. This cross-sectional analysis nested within the 100 Million Brazilian Cohort found an association between BFP receipt and maternal mortality. This association was of greater magnitude in women with longer exposure to BFP and in the most vulnerable groups. These findings reinforce evidence that programs such as BFP, which have already proven effective in poverty reduction, have great potential to improve maternal survival.

Effects of public financing of essential maternal and child health interventions across wealth quintiles in Nigeria: an extended cost-effectiveness analysis

The authors aimed to estimate the health and financial risk protection benefits across different wealth groups in Nigeria if a policy of public financing of MNCH interventions were to be introduced. Findings suggest that public financing of essential MNCH interventions in Nigeria would provide substantial health and financial risk protection benefits to Nigerian households. These benefits would accrue preferentially to the poorest quintiles and would contribute towards reduction of health and socioeconomic inequalities in Nigeria. The distribution would be more pro-poor if public financing of MNCH interventions could target poor households.

Maternal and infant outcomes of Syrian and Palestinian refugees, Lebanese and migrant women giving birth in a tertiary public hospital in Lebanon: a secondary analysis of an obstetric database

This study aims to assess whether the characteristics, management and outcomes of women varied between Syrian and Palestinian refugees, migrant women of other nationalities and Lebanese women giving birth at a public tertiary centre in Beirut, Lebanon. Findings suggest that Syrian refugees in Lebanon had similar obstetric outcomes compared to the host population, except for very preterm birth. However, Palestinian women and migrant women of other nationalities appeared to have worse pregnancy complications than the Lebanese women. There should be better healthcare access and support for migrant populations to avoid severe complications of pregnancy.

Unwinding the tangle of adolescent pregnancy and socio-economic functioning: leveraging administrative data from Manitoba, Canada

This study uses rich administrative data from Manitoba, Canada, to assess women's functioning during childhood (including pre-pregnancy academic performance), fertility behaviors during adolescence (live birth, abortion, pregnancy loss, or no history of pregnancy), and adult outcomes of high school completion and receipt of income assistance. This rich set of covariates allows calculating propensity score weights to help adjust for characteristics possibly predictive of adolescent pregnancy. The study also explore which risk factors are associated with the study outcomes.

Clinical presentation, maternal-fetal, and neonatal outcomes of early-onset versus late onset preeclampsia-eclampsia syndrome in a teaching hospital in a low-resource setting: A retrospective cohort s

The magnitude of preeclampsia-eclampsia and maternal-fetal and neonatal outcomes of early and late onset preeclampsia are not adequately investigated in resource-limited settings. This study sought to examine the clinical presentation and maternal-fetal and neonatal outcome of these two entities of the disease in Ayder comprehensive specialized hospital, an academic setting in Tigray, Ethiopia, from January 1, 2015-December 31, 2021. The present study highlights the clinical differences between early versus late onset preeclampsia. Women with early-onset disease are at increased levels of unfavorable maternal outcomes. Perinatal morbidity and mortality were also increased significantly in women with early onset disease. Therefore, gestational age at the onset of the disease should be taken as an important indicator of the severity of the disease with unfavorable maternal, fetal, and neonatal outcomes.

Survey Call: Help Develop Equitable Research Funding Priorities on Infectious Diseases Sources and Drivers Across the World

The Global Health Network and Wellcome are launching a global survey to gather your perspectives on the research priorities in this area. Our aim is to gain a comprehensive understanding of the most pressing research needs and to form a consensus among different sectors, including human and animal health.

Capacity and quality of maternal and child health services delivery at the subnational primary healthcare level in relation to intermediate health outputs: a cross-sectional study of 12 low-income and

The objective of this study was to examine the capacity and quality of maternal and child health (MCH) services at the subnational primary healthcare (PHC) level in 12 low-income and middle-income countries (LMICs) and its association with intermediate health outputs such as coverage and access to care. The results of this analysis illustrate the heterogeneity in the capacity and quality of PHC service delivery within LMICs. Countries seeking to strengthen their PHC systems could improve PHC monitoring at the subnational level to better understand subnational bottlenecks in service delivery.

Comparing maternal substance use and perinatal outcomes before and during the COVID-19 pandemic

The objective of this study was to examine the effect of the COVID-19 pandemic on maternal substance abuse and neonatal outcomes. Findings suggest that there was a significant increase in maternal fentanyl use during the pandemic, even with OMT enrollment, with an increase in preterm births and lower birth weights among infants born to mothers with substance use. 

Women’s multidimensional empowerment index and essential newborn care practice in Bangladesh: The mediating role of skilled antenatal care follow-ups

This study explored that the prevalence of good essential newborn care (ENC) practice can be accelerated through women’s empowerment, where skilled antenatal care plays an important mediating role in improving good ENC practice among highly empowered mothers. The study suggests that a woman should follow the latest guidelines recommended by WHO for antenatal care follow-up. Policymakers can modify some of the maternal and child health care interventions based on the research findings.