Maternal and Newborn Health Research Roundup – March 2024

Staying up-to-date with recently published research is crucial for accelerating progress in improving maternal and newborn health outcomes worldwide. At AlignMNH, we review, curate, and summarize recently published research each month. By staying informed, we hope that you as the MNH community are equipped to tackle the most pressing issues in maternal and newborn health today, helping to propel us forward as we work together toward achieving our shared global goals.  

This month, our research summaries cover several topics, including strategies to reduce cesarean rates, global trends in low birthweight prevalence, potential biomarkers for pre-eclampsia, the impact of antenatal care on maternal nutrition and breastfeeding, and the need for improved research infrastructure during epidemics. 

1. Researchers have tested a new strategy to reduce unnecessary cesarean sections in India, where the rates of this surgical procedure are high. In a randomized trial involving four hospitals and over 26,000 women, they found that implementing the WHO’s Labour Care Guide (LCG) reduced the cesarean rate by 5.5% among first-time mothers with low-risk pregnancies, without causing harm to the mothers or babies. The study suggests that use of the WHO LCG could help reverse the global trend of rising cesarean sections, especially in low- and middle-income countries. (Nature Medicine, 30 January 2024) 

2. A new study has estimated the prevalence and trends of low birthweight (LBW), defined as less than 2500 g at birth, in 2020 and 2000 for 158 countries and areas. The study, which used data from various sources, including household surveys, health facilities, and vital registration systems, found that the global prevalence of LBW was 14.7% in 2020, corresponding to about 19.8 million LBW livebirths. The study also found that the global prevalence of LBW decreased by 1.9 percentage points between 2000 and 2020, but with substantial regional and country-level variations. Insufficient progress has been made over the past two decades in reducing the number of LBW babies born. To make progress, efforts will need to focus on improving maternal nutrition, antenatal care, and quality of care at birth, particularly for adolescent girls and women living in the most affected countries. Increasing quality and availability of LBW data will aid in better monitoring progress and trend mapping. (The Lancet, 28 February 2024) 

3. A prospective cohort study investigated the potential use of platelet size and count as predictors of early-onset pre-eclampsia, a serious complication of pregnancy. The study enrolled 648 healthy pregnant women between 14-18 weeks of gestation and measured their platelet count (PC), mean platelet volume (MPV), and platelet distribution width (PDW) at recruitment. The women were followed until 34 weeks of gestation, and the occurrence of early-onset pre-eclampsia was recorded. The study found that women who developed pre-eclampsia had higher MPV and PDW, and lower PC, compared to normotensive women. The study also identified cut-off values for PC, MPV, and PDW that could predict early-onset pre-eclampsia with high sensitivity and specificity. The study suggested that platelet size and count could be useful biomarkers for early detection and management of pre-eclampsia, especially in resource-limited settings where other tests are not readily available, but further research is needed. (Maternal Health, Neonatology, and Perinatology, 1 March, 2024)  

4. A multi-country study examined how the timing and frequency of antenatal care (ANC) visits influenced maternal micronutrient intake and breastfeeding practices in South Asia. The study used data from the 2018 South Asia Food and Nutrition Security Initiative (SAFANSI) survey, which covered 10,000 households in Bangladesh, India, Nepal, and Pakistan. The study found that women who started ANC in the first trimester and had at least four ANC visits were more likely to consume iron-folic acid supplements, calcium supplements, and diverse foods during pregnancy, and to initiate breastfeeding within one hour of delivery, compared to women who had late or fewer ANC visits. The study also found that the association between ANC and maternal nutrition and breastfeeding varied by country and by socio-economic factors, such as education, wealth, and urban-rural residence. Researchers concluded that improving the coverage, timing, and quality of ANC could enhance maternal and child  nutrition outcomes in South Asia. (PLOS Global Public Health, 4 March 2024) 

5. Pregnant women and their children are often at increased direct and indirect risks of adverse outcomes during epidemics and pandemics. A coordinated research response is important to ensure that this group is offered at least the same level of disease prevention, diagnosis, and care as the general population. Through a landscape analysis and expert consultations, the authors of this paper found that the infrastructure to support a robust research response during emerging and ongoing epidemic threats remains insufficient, particularly for use of medical products in pregnancy. Limitations in global governance, coordination, funding and data-gathering systems have slowed down research responses. The findings of this landscape analysis and its proposed operational framework will pave the way for developing a roadmap to guide coordination efforts, facilitate collaboration and ultimately promote rapid access to countermeasures and clinical care for pregnant women and their offspring in future epidemics. (BMJ Global Health, 7 March 2024)