Maternal and Newborn Health Research Roundup – July 2024

1.

Neonatal mortality during the war in Tigray: a cross-sectional community-based study 

A recent cross-sectional community-based study highlights the devastating impact of the Tigray war on neonatal mortality, revealing a significant increase in preventable newborn deaths in Ethiopia. This comprehensive research, involving 189,087 households, identified a high neonatal mortality rate, with asphyxia and infection being the primary causes of death in the early and late neonatal periods, respectively. The findings emphasize the urgent need for reinstating lifesaving interventions and improving access to emergency healthcare and medicines. The study also provides crucial data for researchers and policymakers to prioritize interventions, mobilize resources, and develop strategies to reduce neonatal mortality in conflict-affected regions. (May 2024)

2.

Current concepts in postpartum anemia management 

The management of postpartum anemia (PPA) remains a critical challenge, as underscored by a recent comprehensive review that delves into the prevalence, impact, and treatment strategies for PPA, which affects 50-80% of of women globally. The review illuminates the multifaceted nature of PPA, attributing it primarily to untreated iron deficiency and significant peripartum blood loss. The consequences of PPA are far-reaching, with increased maternal morbidity, including fatigue, depression, and impaired cognitive function, which can hinder maternal-child bonding. The study advocates for prompt and effective management strategies, emphasizing the importance of early detection and iron supplementation. It recommends routine hemoglobin level assessments within 24 hours post-birth, particularly when blood loss exceeds 1000 ml, and follow-up evaluations at 4 to 8 weeks postpartum. Intravenous iron supplementation has emerged as a particularly effective treatment, significantly improving hemoglobin levels and reducing physical fatigue within 6 to 12 weeks postpartum. This review serves as a call to action for heightened awareness and improved protocols to address the public health issue of PPA, ensuring better outcomes for mothers and their infants. (June 2024)

3.

Population modifiable risk factors associated with neonatal mortality in 35 sub-Saharan Africa countries: analysis of data from demographic and health surveys 

A recent analysis of Demographic and Health Survey data has pinpointed the most critical modifiable risk factors contributing to neonatal mortality in Sub-Saharan Africa (SSA), where the rates are the highest globally. Using data from Demographic and Health Surveys across 35 SSA countries conducted between 2010 and 2022, researchers employed sophisticated models to estimate the impact of these risk factors. The analysis revealed that delayed initiation of breastfeeding, use of unclean cooking fuel, lack of maternal education, absence of maternal tetanus vaccination, and infrequent antenatal care visits collectively account for nearly 40% of neonatal deaths among singleton children in SSA. Subregional variations were observed, but delayed breastfeeding initiation consistently emerged as the most significant risk factor across Central, Eastern, Southern, and Western SSA. These findings underscore the potential for substantial reductions in neonatal mortality through targeted interventions focused on improving breastfeeding practices, reducing household air pollution, enhancing maternal education, and enhancing the overall perinatal continuum of care. (20 June 2024)

4.

Factors associated with skilled birth attendance in 37 low-income and middle-income countries: a secondary analysis of nationally representative, individual-level data 

A recent secondary analysis of nationally representative, individual-level data has highlighted the uneven progress in skilled birth attendance (SBA) across low- and middle-income countries (LMICs). Leveraging a large dataset from 37 LMICs and over one million births and mothers, the study found that factors like household wealth, rural residency, and female education levels have become less significant predictors of SBA uptake. However, predictors such as female empowerment and maternal health knowledge remain crucial, with regional variations such as rural residency’s continued importance in sub-Saharan Africa and wealth in Southeast Asia. The study underscores the need to dedicate further efforts to developing general and region-specific policies to achieve the SBA Sustainable Development Goals, the Every Newborn Action Plan, and the Ending Preventable Maternal Mortality initiative. (July 2024)

5.

Extreme weather events and maternal health in low-income and middle-income countries: a scoping review 

In a recent scoping review, researchers explored the profound impact of extreme weather events (EWE) on maternal health in low-income and middle-income countries. The study reveals that EWEs are significantly disrupting infrastructure and access to medical services, leading to malnutrition, mental health issues, increased mortality, and hindered access to maternal health services. The review, which included 15 studies, highlighted the association between EWE and adverse maternal health outcomes, emphasizing the urgent need for research to understand the mechanisms behind these effects. The findings underscore the vulnerability of pregnant and postpartum women in resource-poor settings to the effects of climate change, and the critical need for targeted interventions to safeguard maternal health amid increasingly unpredictable climate events. (3 June 2024)

6.

Complexities of implementing Maternal and Perinatal Death Surveillance and Response in crisis-affected contexts: a comparative case study 

A recent study explores the intricate challenges of implementing Maternal and Perinatal Death Surveillance and Response (MPDSR) systems in crisis-affected contexts. The study analyzed five humanitarian settings: Cox’s Bazar refugee camps in Bangladesh, refugee settlements in Uganda, South Sudan, Palestine, and Yemen. The research found that the adoption and fidelity of MPDSR interventions were significantly influenced by the availability of financial and human resources, leadership engagement, health administration, provider buy-in, and community involvement. Despite these efforts, a pervasive blame culture often led to health providers facing punishment or criminalization for perceived negligence. Successful implementation was linked to integrating MPDSR within quality improvement efforts, enhancing community involvement, and adapting programs to fit the specific context. The study underscores the need for a customized approach to MPDSR that aligns with stakeholder priorities and supports health workers in providing care to vulnerable populations. (16 July 2024)