Impact of Maternal Health and Disease on Neonatal Outcome

Abstract

Low birth weight (LBW) and preterm births make babies more vulnerable for disease and death in the neonatal period in India and worldwide (Estimates generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEF) 2018: leading causes of neonatal deaths in India. http://data.unicef.org ). Of the 20 million LBW babies born globally each year, 97% are born in low–middle income countries (40% in India), and 80% of neonatal deaths occur in this group. Unlike LBW, preterm births are prevalent in both high- and low-income countries and are the most common cause of disability and death. Of more than 15 million preterm births (10.6% of total live births), 81% are in Asia and sub-Saharan Africa. In India, premature birth rate is 14 per 1000 live births. Worldwide, 10% of all neonatal deaths occur in premature births (in Indian up to 44% mortality). This risk is on the rise with the increase in preterm birth rate in many countries. Neonatal mortality rate (NMR) is an indicator of a country’s health status. Indian NMR has decreased from 5.7% to 4.1% over 10 years, as in 2017 (Estimates generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEF) 2018: leading causes of neonatal deaths in India. http://data.unicef.org ). Of the various factors impacting NMR, maternal factors (undernutrition, anaemia, and diseases) are most important affecting fetal growth, maturation, and overall neonatal outcome. Surgical mortality in neonates is also very high, varying on a country’s health infrastructure and development, ranging from 6.7% in South Korea (Lee et al., J Korean Assoc Pediatr Surg 2006, http://www.koreamed.org/SearchBasic.php?RID=0053JKAPS/2006.12.2.137&DT=1) to 7.5% in Japan (Taguchi, Surg Today 38:379–89, 2008) and 35% in India (Gangopadhyay et al., Indian J Pediatr 75:1025–30, 2008) to 45% in Nigeria (Chirdan et al., Semin Pediatr Surg 21:151–9, 2012). This chapter will discuss the impact of maternal health and common medical diseases on fetal growth and development and the risks in the baby after birth. This will also affect perioperative morbidity and mortality in the surgical neonates.