scholarly journals Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e021623 ◽  
Author(s):  
Archana Patel ◽  
Amber Abhijeet Prakash ◽  
Prabir Kumar Das ◽  
Swarnim Gupta ◽  
Yamini Vinod Pusdekar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Outcomes ◽  
Mode Of Delivery ◽  
Newborn Health ◽  
Global Network ◽  
Maternal And Newborn Health ◽  
Maternal Complications ◽  
Neonatal Deaths ◽  
Catchment Areas ◽  
Low Bmi

ObjectivesTo study the trend in the prevalence of anaemia and low BMI among pregnant women from Eastern Maharashtra and evaluate if low BMI and anaemia affect pregnancy outcomes.DesignProspective observational cohort study.SettingCatchment areas of 20 rural primary health centres in four eastern districts of Maharashtra State, India.Participants72 750 women from the Nagpur site of Maternal and Newborn Health Registry of NIH’s Global Network, enrolled from 2009 to 2016.Main outcome measuresMode of delivery, pregnancy related complications at delivery, stillbirths, neonatal deaths and low birth weight (LBW) in babies.ResultsOver 90% of the women included in the study were anaemic and over a third were underweight (BMI <18 kg/m2) and with both conditions. Mild anaemia at any time during delivery significantly increased the risk (Risk ratio; 95% confidence interval (RR;(95% CI)) of stillbirth (1.3 (1.1–1.6)), neonatal deaths (1.3 (1–1.6)) and LBW babies (1.1 (1–1.2)). The risks became even more significant and increased further with moderate/severe anaemia any time during pregnancy for stillbirth (1.4 (1.2–1.8)), neonatal deaths (1.7 (1.3–2.1)) and LBW babies (1.3 (1.2–1.4)).,. Underweight at anytime during pregnancy increased the risk of neonatal deaths (1.1 (1–1.3)) and LBW babies (1.2;(1.2–1.3)).The risk of having stillbirths (1.5;(1.2–1.8)), neonatal deaths (1.7;(1.3–2.3)) and LBW babies (1.5;(1.4–1.6)) was highest when - the anaemia and underweight co-existed in the included women. Obesity/overweight during pregnancy increased the risk of maternal complications at delivery (1.6;(1.5–1.7)) and of caesarean section (1.5;(1.4–1.6)) and reduced the risk of LBW babies 0.8 (0.8–0.9)).ConclusionMaternal anaemia is associated with enhanced risk of stillbirth, neonatal deaths and LBW. The risks increased if anaemia and underweight were present simultaneously.Trial registration numberNCT01073475.

scholarly journals Continuity of care and its determinants of routine maternal and newborn health visits in Nepal: Evidence from a nationally representative household survey

2021 ◽  
Author(s):  
Resham Bahadur Khatri ◽  
Rajendra Karkee ◽  
Jo Durham ◽  
Yibeltal Assefa
Keyword(s):  
Continuity Of Care ◽  
Agricultural Sector ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Newborn Health ◽  
Outcome Variable ◽  
Maternal And Newborn Health ◽  
Health Management Information System ◽  
Neonatal Deaths ◽  
Maternal And Newborn

Abstract Background Maternal and newborn health (MNH) is a priority health issue in Nepal, has high maternal and neonatal deaths. Maternal and neonatal deaths can be prevented through uptake of essential antenatal, intrapartum, and postnatal interventions received during routine MNH visits. Not all women, however, receive all recommended routine visits across the MNH Continuum of Care (CoC) in Nepal. This study examined the patterns and determinants of (dis)continuity of care across the MNH continuum. Methods The study included 1,978 women aged 15–49 years who had a live birth in the two years preceding the survey. Data were derived from the Nepal Demographic and Health Survey (NDHS) 2016. The outcome variable was (dis)continuity of care at different stages of MNH visits (at least four antenatal care (4ANC) visits, institutional delivery, and postnatal care (PNC) visit). Several structural, intermediary and health system explanatory variables were included in the analysis. Multinomial logistic regression analysis was conducted, and the magnitude of (dis)continuity of care was reported as relative risk ratios (RR) with 95% confidence intervals (CIs). The statistical significance level was set p<0.05. Results More than two-in-five (41%) women in Nepal received all three MNH visits across the CoC. There was high risk of discontinuity of care during months or weeks prior to childbirth or around childbirth. Higher risk of discontinuation across the CoC was reported among women of disadvantaged ethnic groups, lower wealth status and illiterate. Similarly, women who speak Bhojpuri, provinces six and seven, who had higher birth order (≥4), who involved in agricultural sector, had unwanted last birth had higher risk of discontinuation of MNH visits. Women did not complete all MNH visits if they had poor awareness on health mother groups and if they perceived problem of not having female healthcare providers. Conclusions Women had poor completion of all routine MNH visits. High discontinuation was observed among disadvantaged groups across the COC. Regular monitoring using the composite indicator of continuity of care through routine health management information system is required. Program approaches should focus on disadvantaged women to improve the completion of routine MNH visits and uptake of essential interventions.

scholarly journals Effects of an expanded Uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in Homa Bay, Kenya

2019 ◽  
Vol 4 (3) ◽  
pp. e001254 ◽  
Author(s):  
Maricianah Atieno Onono ◽  
Samuel Wahome ◽  
Pauline Wekesa ◽  
Catherine Kidiga Adhu ◽  
Lawrence Wandei Waguma ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Navigation System ◽  
Prospective Cohort ◽  
Newborn Health ◽  
Standard Of Care ◽  
Text Messages ◽  
Maternal And Newborn Health ◽  
Control Group ◽  
The Impact

IntroductionKenya’s progress towards reducing maternal and neonatal deaths is at present ‘insufficient’. These deaths could be prevented if the three delays, that is, in deciding to seek healthcare (delay 1), in accessing formal healthcare (delay 2) and in receiving quality healthcare (delay 3), are comprehensively addressed. We designed a mobile phone enhanced 24 hours Uber-like transport navigation system coupled with personalised and interactive gestation-based text messages to address these delays. Our main objective was to evaluate the impact of this intervention on women’s adherence to recommended antenatal (ANC) and postnatal care (PNC) regimes and facility birth.MethodsWe conducted a prospective cohort study. Women were eligible to participate in the study if they were 15 years or older and less than 28 weeks gestation. We defined cases as those who received the standard of care plus the intervention and the control group as those who received the standard of care only. For analysis, we used logistic regression analysis and report crude and adjusted OR (aOR) and 95 % CI.ResultsCases (women who received the intervention) had five times higher odds of having four or more ANC visits (aOR=4.7, 95% CI 3.20 to 7.09), three times higher odds of taking between 30 and 60 min to reach a health facility for delivery (aOR=3.14, 95% CI 2.37 to 4.15) and four times higher odds of undergoing at least four PNC visits (aOR=4.10, 95% CI 3.11 to 5.36).ConclusionAn enhanced community-based Uber-like transport navigation system coupled with personalised and interactive gestation-based text messages significantly increased the utilisation of ANC and PNC services as well as shortened the time taken to reach an appropriate facility for delivery compared with standard care.

scholarly journals The Maternal and Newborn Health Registry Study of the Global Network for Women's and Children's Health Research

2012 ◽  
Vol 118 (3) ◽  
pp. 190-193 ◽  
Author(s):  
Shivaprasad S. Goudar ◽  
Waldemar A. Carlo ◽  
Elizabeth M. McClure ◽  
Omrana Pasha ◽  
Archana Patel ◽  
...  
Keyword(s):  
Health Research ◽  
Newborn Health ◽  
Children's Health ◽  
Global Network ◽  
Children’S Health ◽  
Maternal And Newborn Health ◽  
Registry Study ◽  
Health Registry ◽  
Maternal And Newborn

scholarly journals Factors associated with delayed initiation of breastfeeding in health facilities: secondary analysis of Bangladesh demographic and health survey 2014

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shahreen Raihana ◽  
Ashraful Alam ◽  
Tanvir M. Huda ◽  
Michael J. Dibley
Keyword(s):  
Health Facility ◽  
Health Survey ◽  
Mode Of Delivery ◽  
Newborn Health ◽  
Demographic And Health Survey ◽  
Maternal Health Service ◽  
Maternal And Newborn Health ◽  
Factors Associated ◽  
Delayed Initiation ◽  
Initiation Of Breastfeeding

Abstract Background Irrespective of the place and mode of delivery, ‘delayed’ initiation of breastfeeding beyond the first hour of birth can negatively influence maternal and newborn health outcomes. In Bangladesh, 49% of newborns initiate breastfeeding after the first hour. The rate is higher among deliveries at a health facility (62%). This study investigates the maternal, health service, infant, and household characteristics associated with delayed initiation of breastfeeding among health facility deliveries in Bangladesh. Methods We used data from the 2014 Bangladesh Demographic and Health Survey. We included 1277 last-born children born at a health facility in the 2 years preceding the survey. ‘Delayed’ breastfeeding was defined using WHO recommendations as initiating after 1 h of birth. We performed univariate and multivariable logistic regression to determine factors associated with delayed initiation. Results About three-fifth (n = 785, 62%) of the children born at a health facility delayed initiation of breastfeeding beyond 1 h. After adjusting for potential confounders, we found delayed initiation to be common among women, who delivered by caesarean section (adjusted Odds Ratio (aOR): 2.93; 95% CI 2.17, 3.98), and who were exposed to media less than once a week (aOR: 1.53; 95% CI 1.07, 2.19). Women with a higher body mass index had an increased likelihood of delaying initiation (aOR: 1.05; 95% CI 1.01, 1.11). Multiparous women were less likely to delay (aOR: 0.71; 95% CI 0.53, 0.96). Conclusions Delayed initiation of breastfeeding following caesarean deliveries continues to be a challenge, but several other health facility and maternal factors also contributed to delayed initiation. Interventions to promote early breastfeeding should include strengthening the capacity of healthcare providers to encourage early initiation, especially for caesarean deliveries.

scholarly journals The Global Network Maternal Newborn Health Registry: a multi-national, community-based registry of pregnancy outcomes

2015 ◽  
Vol 12 (S2) ◽  
Author(s):  
Carl L Bose ◽  
Melissa Bauserman ◽  
Robert L Goldenberg ◽  
Shivaprasad S Goudar ◽  
Elizabeth M McClure ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Newborn Health ◽  
Global Network ◽  
Community Based ◽  
National Community ◽  
Health Registry

scholarly journals The Global Network Maternal Newborn Health Registry: a multi-country, community-based registry of pregnancy outcomes

2020 ◽  
Vol 17 (S2) ◽  
Author(s):  
Elizabeth M. McClure ◽  
Ana L. Garces ◽  
Patricia L. Hibberd ◽  
Janet L. Moore ◽  
Shivaprasad S. Goudar ◽  
...  
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Newborn Health ◽  
Population Based ◽  
Global Network ◽  
Resource Limited ◽  
Health Registry ◽  
Population Based Registry ◽  
Over Time

Abstract Background The Global Network for Women's and Children’s Health Research (Global Network) conducts clinical trials in resource-limited countries through partnerships among U.S. investigators, international investigators based in in low and middle-income countries (LMICs) and a central data coordinating center. The Global Network’s objectives include evaluating low-cost, sustainable interventions to improve women’s and children’s health in LMICs. Accurate reporting of births, stillbirths, neonatal deaths, maternal mortality, and measures of obstetric and neonatal care is critical to determine strategies for improving pregnancy outcomes. In response to this need, the Global Network developed the Maternal Newborn Health Registry (MNHR), a prospective, population-based registry of pregnant women, fetuses and neonates receiving care in defined catchment areas at the Global Network sites. This publication describes the MNHR, including participating sites, data management and quality and changes over time. Methods Pregnant women who reside in or receive healthcare in select communities are enrolled in the MNHR of the Global Network. For each woman and her offspring, sociodemographic, health care, and the major outcomes through 42-days post-delivery are recorded. Study visits occur at enrollment during pregnancy, at delivery and at 42 days postpartum. Results From 2010 through 2018, the Global Network MNHR sites were located in Guatemala, Belagavi and Nagpur, India, Pakistan, Democratic Republic of Congo, Kenya, and Zambia. During this period at these sites, 579,140 pregnant women were consented and enrolled in the MNHR, nearly 99% of all eligible women. Delivery data were collected for 99% of enrolled women and 42-day follow-up data for 99% of those delivered. In this supplement, the trends over time and assessment of differences across geographic regions are analyzed in a series of 18 manuscripts utilizing the MNHR data. Conclusions Improving maternal, fetal and newborn health in countries with poor outcomes requires an understanding of the characteristics of the population, quality of health care and outcomes. Because the worst pregnancy outcomes typically occur in countries with limited health registration systems and vital records, alternative registration systems may prove to be highly valuable in providing data. The MNHR, an international, multicenter, population-based registry, assesses pregnancy outcomes over time in support of efforts to develop improved perinatal healthcare in resource-limited areas. Trial Registration The Maternal Newborn Health Registry is registered at Clinicaltrials.gov (ID# NCT01073475). Registered February 23, 2019. https://clinicaltrials.gov/ct2/show/NCT01073475

scholarly journals Feto maternal outcome in eclampsia after 28 weeks of pregnancy: vaginal delivery versus caesarean section

2017 ◽  
Vol 6 (9) ◽  
pp. 3875
Author(s):  
Bhawna Madan
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Signs And Symptoms ◽  
Fetal Outcome ◽  
Maternal Complications ◽  
Maternal Deaths ◽  
Neonatal Deaths ◽  
Still Births

Background: Eclampsia is the occurrence of convulsions or coma unrelated to other cerebral condition with signs and symptoms of preeclampsia. Objective of present study was the comparison of maternal and fetal outcome of women with more than 28 weeks gestation complicated by antepartum eclampsia when terminated either by caesarean section or by vaginal delivery.Methods: 200 Women with more than 28 weeks of gestation with antepartum eclampsia were studied from admission to discharge or death. Depending upon the mode of delivery, they were divided into two groups: C.D. group. Where caesarean section was performed and V.D. group, where vaginal delivery was carried out. Maternal and Perinatal outcome were studied in the two groups and compared.Results: Of the 200 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried out in 60%. Maternal complications were seen in 15% of the cases in the C.D group and 60% of the cases in the V.D. group. Maternal deaths occurred in none of the case in the C.D group and in 33% of the cases in the V.D group. The incidence of live births, still births and neonatal deaths was 87.8%, 2.43% and 9.75% respectively in the C.D group, while it was 49.16%, 45.16% and 9.67% in the V.D group The Corrected perinatal mortality was 9.75% in the C.D group and 43.55% in the V.D group. Apgar score less than 5 at l minute was seen in 35% cases in the C.D group and 82.35% cases in the V.D group.30% of the cases in the C.D group and 76.47% of the cases in the V.D group required NICU admission.Conclusions: Timely caesarean section reduces maternal and Perinatal mortality and improves their outcome in antepartum eclampsia, especially in women with more than 28 weeks of pregnancy.

Sign in / Sign up

Export Citation Format

Share Document