Articles

GDF15 linked to maternal risk of nausea and vomiting during pregnancy

GDF15, a hormone acting on the brainstem, has been implicated in the nausea and vomiting of pregnancy, including its most severe form, hyperemesis gravidarum (HG), but a full mechanistic understanding is lacking. Here the authors report that fetal production of GDF15 and maternal sensitivity to it both contribute substantially to the risk of HG.

Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4-year-old children

This study assessed the effects of adjusting prenatal iron supplementation to maternal iron stores during early pregnancy on children's behavioural problems. Findings suggest that adjusting prenatal iron supplementation to both maternal baseline Hb levels and iron stores reduces behavioural problems in 4-year-old children.

Maternal interventions to decrease stillbirths and neonatal mortality in Tanzania: evidence from the 2017-18 cross-sectional Tanzania verbal and social autopsy study

The authors conducted a national verbal and social autopsy (VASA) study to estimate the causes and social determinants of stillbirths and neonatal deaths with the aim of identifying relevant health care and social interventions. Findings suggest that while quality antenatalcare (Q-ANC) and four or more ANC visit (ANC4 +) boosted hospital delivery among women with a complication, attendance was low and the quality of care is critical. Quality improvement efforts in urban and rural areas should focus on early detection and management of APH, maternal anemia, PROM, and prolonged labor, and on newborn resuscitation.

Association of breastfeeding and neonatal jaundice with infant neurodevelopment

Data comes from the Jiangsu Birth Cohort (JBC), a prospective and longitudinal birth cohort study in China. A total of 2577 infants born from November 2017 to March 2021 were included in the analysis. Multivariate linear regression models were used to analyze the associations between breastfeeding status, neonatal jaundice, and their interaction with infant neurodevelopment. Findings suggest that exclusive breastfeeding for the first six months is beneficial to the neurodevelopment of infants, especially in those with severe neonatal jaundice.

Breastfeeding duration and associations with prevention of accelerated growth among infants from low-income, racially, and ethnically diverse backgrounds

The objective of this study was to describe breastfeeding rates from early to late infancy and to examine associations between breastfeeding duration and infant growth, including rapid weight gain (RWG, > 0.67 standard deviations increase in weight-for-age z-score), among infants from low-income, racially, and ethnically diverse backgrounds. Findings suggest that breastfeeding beyond 6 months is associated with the prevention of accelerated growth among infants from low-income, racially, and ethnically diverse backgrounds, suggesting progress toward health equity.

Associations Between Gestational Weight Gain, Gestational Diabetes, and Childhood Obesity Incidence

The purpose of this study was to investigate whether overall and trimester-specific maternal gestational weight gain GWG and gestational diabetes mellitus GDM were associated with obesity in offspring by age 6 years. Results indicated total and trimester-specific maternal weight gain was a strong predictor of early childhood obesity, though obesity risk by age 6 was lower for children of mothers with GDM. Additional research is needed to elucidate underlying mechanisms directly related to trimester-specific weight gain and GDM that impede or protect against obesity prevalence during early childhood.

The Racial Disparity of Severe Maternal Morbidity Across Weeks of Gestation: A Cross-Sectional Analysis of the 2019 National Inpatient Sample

Severe maternal morbidity (SMM) is increasing in the United States. Black women experience the highest rates of SMM and also of preterm births, which are associated with SMM. The racial disparity of SMM across weeks of gestation has not been well-studied. The objective of this study was to evaluate differences in SMM between Black and White birthing people by week of gestation. Findings suggest that black women experience a substantially higher rate of SMM at preterm gestations (22-36 weeks) in addition to higher rates of preterm delivery. Even when accounting for age, medical comorbidities, and social determinants, Black birthing people have a higher odds of SMM throughout pregnancy.

Understanding the lived experience of pregnancy and birth for survivors of rape and sexual assault

This qualitative research took an intersectional feminist approach. The authors conducted in-depth individual interviews in England with fourteen women who self-identified as survivors of rape or sexual assault, and who had experienced pregnancy and birth after the assault. Findings suggest that survivors of sexual violence have specific maternity care needs. For our participants, these needs were often not met, leading to negative or traumatic experiences of pregnancy and birth. Systemic biases and poor birth experience jeopardise both psychological and physical safety. Funding for maternity and mental health services must be improved, so that they meet minimum staffing and care standards. Maternity services should urgently introduce trauma-informed models of care.

Racial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018-2021

Findings from this study suggests that compared to pre-pandemic, the odds of not receiving adequate prenatal care in South Carolina was increased by 10% for White women and 26% for Black women during the pandemic, highlighting the needs to develop individual tailored interventions to reverse this trend.

Neonatal and Maternal Outcomes at 22-28 Weeks of Gestation by Mode of Delivery

Findings from this study suggests that cesarean delivery in cephalic fetuses was associated with increased odds of adverse neonatal outcomes (24 weeks of gestation or greater) and SMM (all gestational age groups). Cesarean delivery was associated with decreased odds of neonatal death compared with vaginal delivery for noncephalic fetuses in all gestational age groups.

Racial Inequities in Drug Tests Ordered by Clinicians for Pregnant People Who Disclose Prenatal Substance Use

Findings from this study suggests that when pregnant people disclosed drug use, clinicians were more likely to order urine drug testing for Black pregnant people compared with their White counterparts, suggesting clinician racial bias. Current practice patterns and protocols such as urine drug testing in pregnancy care deserve review to identify and mitigate areas of potential clinician discrimination.

Preventing Eviction During Pregnancy: A Cost-Effectiveness Analysis of a Theoretical Safety-Net Program

The objective of the study was to evaluate the cost-effectiveness of a program covering the cost of rent to prevent eviction during pregnancy. The no eviction strategy is cost-effective and reduces cases of preterm birth, neonatal death, and neurodevelopmental delay. When rent is below the median of $1,016 per month, no eviction is the cost-saving strategy. These findings suggest that policies supporting social programmatic implementation for rent coverage for pregnant people at risk of eviction have the potential to be highly beneficial in reducing costs and disparities in perinatal outcomes.

Breastfeeding moderates childhood obesity risk associated with prenatal exposure to excessive gestational weight gain

This study examined the associations between gestational weight gain (GWG), breastfeeding during infancy and childhood obesity at 2–4 years, and determined whether breastfeeding moderated the association between GWG and childhood obesity. Findings suggested that longer fully breastfeeding duration may provide greater protection against obesity among children at higher risk due to intrauterine exposure to high gestational weight gain.

Physical violence during pregnancy in sub-Saharan Africa: why it matters and who are most susceptible?

The study assessed the prevalence of physical violence against pregnant women and its associated factors in sub-Saharan Africa (SSA). Based on the findings, community leaders are encouraged to liaise with law enforcement agencies to strictly enforce laws on gender-based violence by prosecuting perpetrators of IPV against pregnant women as a deterrent. Also, intensifying education on what constitutes IPV and the potential consequences on the health of pregnant women, their children, and their families will be laudable. Improving the socioeconomic status of women may also help to eliminate IPV perpetration against women at their pregnancy stage.

Is there a relation between stillbirth and low levels of vitamin D in the population? A bi-national follow-up study of vitamin D fortification

The authors aimed to assess the odds of stillbirth in relation to changes in national vitamin D fortification. Findings suggest that each increment of vitamin D fortification was associated with a 15% drop in stillbirths on a national level. If true, and if fortification reaches the entire population, it may represent a milestone in preventing stillbirths and reducing health inequalities.

Unplanned pregnancy and the association with maternal health and pregnancy outcomes: A Swedish cohort study

The aims were to study whether pregnancy planning was associated with antenatal care utilization and pregnancy outcomes in a Swedish setting. Findings suggest that unplanned pregnancy was associated with delayed initiation of antenatal care, higher odds for induction of labor and longer hospital stay, but not with any severe pregnancy outcomes. These findings suggest that women with an unplanned pregnancy cope well in a setting with free abortion and free health care.

Experiences of childbirth care among immigrant and non-immigrant women: a cross-sectional questionnaire study from a hospital in Norway

This study aimed to investigate immigrant and non-immigrant women's experiences of health care during childbirth, particularly assessing two dimensions: perceived general quality of care and attainment of health care needs during childbirth. Findings indicate that many women feel they receive high-quality health care during childbirth, but a considerable number still report not having their health care needs met. Also, multiparous immigrant women report significantly more unmet health care needs than non-immigrants. Further research is required to assess immigrant women's childbirth experiences and for health care providers to give optimal care, which may need to be tailored to a woman's cultural background and individual expectations.

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.