Infant Morbidity Research Articles

Prenatal homelessness, food insecurity, and unemployment and adverse infant outcomes in a California cohort, 2007-2020.

Characterize the relationship between infant outcomes and prenatal homelessness, food insecurity and unemployment. California live births between 22- and 44-weeks' gestation comprised 6,089,327 pregnancies (2007-2020). Data were collected from linked Vital Statistics and hospital discharge records. Prenatal homelessness, food insecurity, and unemployment were classified as health-related social needs (HRSN) using International Classification of Disease codes in delivery records. Risk ratios for preterm birth, low birthweight, small for gestational age, neonatal intensive care unit admission, emergency department admission, rehospitalization, and death were estimated using log-linear Poisson regression adjusted for birthing person race, payer, and education. 65.7 per 100,000 births had HRSN. These infants had a higher risk of preterm birth (aRR 2.7), low birthweight (aRR 2.7), SGA (aRR 1.5), NICU admission (aRR 3.5), and death (aRR 3.0). HRSN increase the risk of infant morbidity and mortality but remain underreported in administrative records, making definitive conclusions difficult.

Comparing nSOFA, CRIB-II, and SNAPPE-II for predicting mortality and short-term morbidities in preterm infants ≤32 weeks gestation

Background Neonatal illness severity scores are not extensively studied for their ability to predict mortality or morbidity in preterm infants. The aim of this study was to compare the Neonatal Sequential Organ Failure Assessment (nSOFA), Clinical Risk Index for Babies-II (CRIB-II), and Score for Neonatal Acute Physiology with Perinatal extension-II (SNAPPE-II) for predicting mortality and short-term morbidities in preterm infants ≤32 weeks. Methods In this retrospective study, infants born in 2017–2018 with gestational age (GA) ≤32 weeks were evaluated. nSOFA, CRIB-II, and SNAPPE-II scores were calculated for each patient, and the ability of these scores to predict mortality and morbidities was compared. The morbidities were categorized as mod/sev bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) requiring surgery, early-onset sepsis (EOS), late-onset sepsis (LOS), retinopathy of prematurity (ROP) requiring treatment, and severe intraventricular hemorrhage (IVH). Calculating the area under the curve (AUC) on receiver operating characteristic curves (ROC) analysis to predict and compare scoring systems’ accuracy. Results A total of 759 preterm infants were enrolled, of whom 88 deceased. The median nSOFA, CRIB-II, and SNAPPE-II scores were 2 (0, 3), 6 (4, 8), and 13 (5, 26), respectively. Compared with infants who survived, these three scores were significantly higher in those who deceased (p < 0.05). For predicting mortality, the AUC of the nSOFA, SNAPPE-II, and CRIB-II were 0.90, 0.82, and 0.79, respectively. The nSOFA scoring system had significantly higher AUC than CRIB-II and SNAPPE-II (p < 0.05). However, short-term morbidities were not strongly correlated with these three scoring systems. Conclusion In infants ≤32 weeks gestation, nSOFA scoring system is more valuable in predicting mortality than SNAPPE-II and CRIB-II. However, further studies are required to assess the predictive power of neonatal illness severity scores for morbidity.

Elevated Interleukin-6 Levels as a Potential Marker of Neonatal Morbidity in Full-term Infants With Polycythemia: A Prospective Study.

To research and show that interleukin-6 (IL-6) and c-reactive protein (CRP), which can be used as infection markers, are also higher among newborns with polycythemia. The study took place in the neonatal intensive care unit of Zekai Tahir Burak Maternity Teaching and Research Hospital. Infants with a gestational age of >37 weeks were included in the study. Infants with chorioamnionitis, perinatal asphyxia, and positive blood culture were excluded from the study. Blood samples were obtained six hours after the delivery from the peripheral vein of the infants for measurements of central hematocrit, blood culture, IL-6, and CRP. Infants with a venous hematocrit value of >65% were grouped as the "polycythemia group," and the ones with a venous hematocrit value of <65% were designated as the "control group." Observation of significantly higher levels of CRP and IL-6 among newborns admitted to the neonatal intensive care unit due to different causes (such as respiratory distress, hypoglycemia, and feeding intolerance), but significantly higher IL-6 levels in newborns with polycythemia. Thirty-five newborns (18 infants in the polycythemia group and 17 infants in the control group) were enrolled in the study. The IL-6 values for the polycythemia group were higher than the upper normal limits (mean ± 2SD, 37.6 ± 55 vs 12 ± 5pg/dL, respectively; P = 0.00). The IL-6 values of the polycythemia group were found to be higher than the IL-6 values of the control group, with a mean ± 2SD of 37.6 ± 55 vs 6.3 ± 3.4pg/dL, respectively; this was significant (P = 0.00). Although the CRP values of the polycythemia group were found to be slightly higher than those of the control group (a mean ± 2SD of 3.06 ± 4.07 vs 1.54 ± 2.21mg/dL, respectively, P > 0.05), this was not significant. This study found a significant and robust statistical correlation between IL-6 and v. Hct values (P = 0.01, rs = 0.641). Contrary to IL-6 levels, however, a meaningful relationship was not found between CRP and v.htc values (P = 0.286; rs = 0.184).

The role of progesterone preparations in the prevention of premature birth: a modern view of the problem

Despite significant progress achieved in healthcare, preterm birth is an urgent problem in modern obstetrics. The preterm birth can be caused by various risk factors: for example, an ascending infection can trigger the onset of uterine contractions, cervical shortening followed by infection of the fetal membranes, amniotic fluid, and, in rare cases, the fetus itself. In most cases, the infectious and inflammatory process is the etiopathogenetic factor of isthmic-cervical insufficiency (ICI), one of the common causes of late miscarriages and preterm births. The period between 14 and 20 weeks of gestation is the most critical time for the development of ICI. The dynamic ultrasound cervicometry once every 7–14 days from week 16 through week 24 of pregnancy is recommended to the patients with ICI, as well as pregnant women in the high-risk group. Most professional societies guidelines addressing this issue recommend all pregnant women to perform routine transvaginal cervicometry during the second ultrasound screening for the timely formation of risk groups and optimization of approaches to the patient management. The following groups of drugs are used to prevent preterm birth: micronized progesterone, slow calcium channel blockers, β-adrenergic agonists, and non-steroidal anti-inflammatory drugs. The use of progesterone drugs to prevent preterm birth has generated much debate. Thus, the availability of several forms of progesterone and various routes of administration determine the complexity of the drug therapy. Micronized progesterone is the only progesterone drug that was approved for use after 20 weeks of gestation. The vaginal micronized progesterone has been found to be highly effective in the prevention of preterm birth, significantly reduce neonatal mortality and improve infant morbidity outcomes.

Evaluation of Sectio Cesaria Response Time to Maternal and Neonatal Outcomes in Severe Preeclampsia - Eclampsia Patients

This research is finding out an overview of the response time evaluation of Sectio Cesaria in patients with severe Pre-eclampsia - Eclampsia at Sitti Khadijah 1 Muhammadiyah Hospital Makassar Branch. Severe preeclampsia and eclampsia are complications in pregnancy and childbirth that increase maternal and infant morbidity and mortality rates. To prevent the problem of eclampsia, early management of preeclampsia must be carried out properly. Cesarean sections are classified into two categories, namely SC categories 1 and 2. Category 1 Caesarean sections are SCs that must be carried out as soon as possible and most decisions must be taken within 30 minutes, namely in cases that immediately threaten the lives of the mother and baby, such as fetal distress, non-reassuring fetal status, antepartum hemorrhage, and the threat of uterine rupture. While SC category 2 is one that endangers the mother and fetus but not immediately, such as two previous CS, dystocia, hypertension in pregnancy, premature rupture of membranes, breech position, failed induction, bad obstetric history, macrosomia, cephalopelvic disproportion, facial presentation, and most decisions must be taken within 75 minutes. This research method is observational research using a cross sectional approach. The results of this research is maternal outcome most affected by SC response time &lt;75 minutes is postoperative ICU care, and the most influential neonatal outcome is the APGAR Score. Based on the research results, it can be concluded that response time has a significant influence on maternal and neonatal outcomes in patients with severe preeclampsia - eclampsia.

Insight into the post-translational modifications in pregnancy and related complications.

Successful pregnancy is dependent on a number of essential events, including embryo implantation, decidualization and placentation. Failure of the above process may lead to pregnancy-related complications, including preeclampsia (PE), gestational diabetes mellitus (GDM), preterm birth, fetal growth restriction (FGR), etc., may affect 15% of pregnancies, and lead to increased mortality and morbidity of pregnant women and perinatal infants, as well as the occurrence of short-term and long-term diseases. These complications have distinct etiology and pathogenesis, and the present comprehension is still lacking. Post-translational modifications (PTMs) are important events in epigenetics, altering the properties of proteins through protein hydrolysis or the addition of modification groups to one or more amino acids, with different modification states regulating subcellular localization, protein degradation, protein-protein interaction, signal transduction and gene transcription. In this review, we focus on the impact of various PTMs on the progress of embryo and placenta development and pregnancy-related complications, which will provide important experimental bases for exploring new insights into the physiology of pregnancy and pathogenesis associated with pregnancy complications.

Disorders of Coagulation in the Newborn.

The coagulation system in newborns varies from that of children and adults, with many circulating hemostatic factors being lower in the newborn. Infants are also susceptible to diseases and conditions in the pregnant person affecting their coagulation system, which can make it difficult to rapidly identify the cause behind coagulopathy in a neonate. Coagulation disorders can result in high levels of infant morbidity and mortality, which makes early diagnosis and prompt treatment critical. This review outlines the clinical characteristics, diagnosis and management, epidemiology, and etiologies of both common and uncommon congenital and acquired forms of neonatal coagulopathy.

COMPARISON OF PLGF LEVELS, AMONG SMALL FOR GESTATIONAL AGE AND APPROPRIATE FOR GESTATIONAL AGE MOTHERS

Objective. Early detection of small for gestational age fetuses can prevent infant morbidity and mortality. The objective of this study was to compare the levels of Placental Growth Factor among small for gestational age with appropriate for gestational age mothers and to identify the predictive value of PlGF in detecting pregnancies with Intra uterine growth retardation in local population. Design. Quasi experimental (comparative cross-sectional) study. Place &amp; duration of study. Gynecological department of Ayub Medical complex, Abbottabad from August 2021 to January 2022. Methodology. The studied population included total 68 mothers in last trimester with 34 in each group, i.e. appropriate for gestational age and small for gestational age. Fetal size was estimated either by clinical examination (symphysis fundal height) or estimated fetal weight by ultrasound examination. Sociodemographic along with reproductive history were recorded and blood samples analyzed for PlGF difference in both groups. Results. The median age of mothers was 32.5 years. The PlGF in small for gestational age was observed in the below normal concentration (mean value = 126.7 pg/mL) while it was observed in normal ranges in appropriate for gestational age mothers (mean value = 24.2 pg/ml) with P-value (&lt;0.001). Conclusion. Mothers with small for gestational age were having significantly lower placental growth factor levels compared to mothers with appropriate for gestational age.

Management of Blood sugar levels in hypreglycemia in pregnancy HIP reduces perinatal, infant morbidity &amp;mortality as a results of large prospective cohort learn from Uttar pradesh

Since the last decade, diabetes mellitus has been emerging as an important public health problem in India owing to the increasing prevalence rate. As many studies have indicated, GDM is an emerging public health problem in pregnant women in India. Randon sample survey across many cities of India have shown prevalence rate varies across different cities as shown in Kanpur 13.4%, Haryana 7.1%, Kashmir 3.8%, south India 21%.

Cardiogenic Necrotizing Enterocolitis in Infants with Congenital Heart Disease: A Systematic Review and Meta-analysis.

Necrotizing enterocolitis (NEC) is a known cause of morbidity and mortality in infants with congenital heart disease (CHD), but reports about the burden of cardiogenic NEC frequently conflict. To synthesize the extant literature on the incidence, risk factors, and prognosis of NEC in patients with CHD. Medline, Cochrane, and EMBASE were searched from 1946 through 2023 for studies of NEC in infants 0-12months of age with CHD. Risk of bias was assessed with validated tools for incidence and risk factors. Pooled estimates were meta-analyzed by risk of bias or synthesized without meta-analysis. Eighty-six studies with a total of 67,924 participants were included. The incidence of cardiogenic NEC was 7.1% (95% CI 4.7-10.5%) in term infants and 13.0% (10.2-16.5%) in low birthweight preterm infants. NEC required surgery in 0.8% (0.5-1.1%) of term and 2.7% (2.0-3.7%) of premature infants, respectively. Only gestational age and birth weight were consistently associated with risk of NEC. Restricting pooled estimates to studies of moderate or low risk of bias significantly reduced the number of studies included. Necrotizing enterocolitis is a common cause of morbidity in infants with CHD, but additional research is needed to determine which infants are at highest risk of developing NEC and would benefit most from a change in management. This systematic review and meta-analysis was conducted according to a prespecified protocol registered at the Prospective Register of Systematic Reviews (CRD42021282114).

005. The Role of Interleukin-8 in Assisting the Diagnosis of Necrotizing Enterocolitis (NEC) Bell’s Stage I and II in Premature Infants: Literature Review

Background: Necrotizing enterocolitis (NEC) is one of the leading causes of morbidity and mortality in infants, commonly associated with extremely low birth weight (ELBW), low birth weight (LBW), and prematurity. The clinical symptoms are nonspecific and various. This poses a challenge in the early diagnosis. The incidence worldwide ranges from 0.3 to 2.4 per 1,000 live births, with mortality rates reaching 50%. This study aims to assess the role of biomarker IL-8 in diagnosing NEC Bell's stage I and II. Methods: This study is a literature review, conducted electronically in databases including Cochrane Library, PubMed, ScienceDirect, and EBSCO using the keywords: ("Interleukin-8" OR "IL-8") AND ("Necrotizing enterocolitis" OR "NEC" OR “Early NEC” OR “Stage I-II NEC”). Inclusion criteria are study in human, English fulltext within 5 years. Exclusion criteria is comparing NEC any stage with control patients, Results: Based on a review of 23 literatures, there were 6 studies met the inclusion criteria for analysis. IL-8 shows varying sensitivity and specificity as a serum biomarker for diagnosing NEC. Statistical evaluations in previous studies emphasized that significantly elevated levels of biomarker IL-8 were predominantly found in the serum of premature infants with NEC, indicating it could be a potential biomarker for diagnosis with NEC Bell's stage I and II. Conclusion: The measurement of biomarker IL-8 in blood has not yet been established as a reliable diagnostic modality for NEC Bell's stage I and II, indicating the need for further investigation.

Di-(2-ethylhexyl) Phthalate Exposure Induces Developmental Toxicity in the Mouse Fetal Heart via Mitochondrial Dysfunction.

Congenital heart disease (CHD) is a major cause of infant mortality and morbidity, with growing interest in the role of environmental factors in its etiology. Di-(2-ethylhexyl) phthalate (DEHP), an environmental endocrine disruptor, has been implicated in the development of CHD. This study aimed to investigate the effects of DEHP exposure on fetal heart development in mice. Pregnant mice exposed to DEHP exhibited increased fetal malformations, decreased fetal weight, and reduced crown-rump length.f Transcriptomic analysis revealed the downregulation of genes involved in aerobic respiration and mitochondrial ATP synthesis. Functional assays demonstrated reduced mitochondrial respiration, decreased ATP production, elevated reactive oxygen species levels, and lowered mitochondrial membrane potential in DEHP-exposed fetal cardiomyocytes. These findings underscore the detrimental effects of DEHP on fetal cardiac health and provide insights into the molecular mechanisms underlying DEHP-induced CHD. Understanding these mechanisms is crucial for developing preventive strategies against environmental toxicants that affect fetal cardiac development.

Prevalence of unplanned first pregnancy and socioeconomic factors in Benin: a cross-sectional and analytical study

BackgroundEarly or unplanned pregnancy is an obstacle to the well-being of adolescent girls, especially as early motherhood has health and social consequences on the young mother and the newborn. This...

Implementation Strategies Used to Reduce UEs in the Neonatal Intensive Care Unit.

Unplanned extubation (UE) is the premature or unintended removal of an artificial airway and can cause worse patient outcomes. Study objectives were to describe implementation strategies used to reduce UE in the Hospital for Sick Children neonatal ICU (NICU) and their influence on UE rates, and contributing factors and patient characteristics of infants who had an UE, and compare them between the biological sexes. We hypothesized that the boys would experience more UEs and worse outcomes compared to the girls. The single-center retrospective cohort study included all infants who experienced UE (2007-2019). Outcomes consisted of implementation reduction strategies developed by using the plan-do-study-act quality-improvement methodology and UE characteristics, including patient (eg, sex, length of stay) and unplanned extubation situation characteristics (eg, events and/or procedures, repeats). Five plan-do-study-act cycles were implemented. Analyses included text summaries of all strategies, and quantitative descriptive and comparative statistics. UE per 100 ventilator days decreased from 3.46 to 0.14. Key success factors included setting achievable goals; ensuring that strategies were evaluated and amended; maintaining consistency over the long-term; incorporating strategies in the NICU; having institutional support and validation; and having good communication. There were 302 UE in 257 infants, 141 boys (55%), average ± SD gestational age of 31 ± 6 weeks, and 31 (12%) had 45 repeated UEs. The only significant difference between the biological sexes was that more boys (129 [92%]) versus girls (94 [83%]) received the Hospital for Sick Children NICU endotracheal tube taping protocol (P = .030). The incidence of UE occurred in a 2-peaked pattern, highest for those < 32 weeks and ≥ 32 weeks of gestational age. Infants < 32 weeks of gestational age and with repeated UE had longer durations of invasive mechanical ventilation and length of stay. For infants <32 versus => 32 weeks gestational age, the median (interquartile range) duration of mechanical ventilation was 38 (16-77) d versus 6 (3-13) d and hospital length of stay 61 (30-100) d versus 16 (10-41) d. For infants with repeated versus no repeated unplanned extubations, duration of mechanical ventilation was 69 (26-125) d versus 13 (4-52) d and hospital length of stay 90 (39-137) d versus 32 (12-75) d. Detailed well-planned UE reduction strategies significantly reduced the rate of UEs with key factors of success identified. UE characteristics and infant morbidity did not differ between the biological sexes. Infants < 32 weeks of gestational age and with repeated UE had a longer duration of mechanical ventilation and length of stay.

Effectiveness of psychoeducation interventions for pregnant women with gestational diabetes mellitus: an integrative review

BackgroundGestational diabetes mellitus occurs in approximately 15–17% of pregnant women worldwide and causes high mortality and morbidity for mothers and infants. Pregnant women who are newly diagnosed with gestational diabetes mellitus experience higher levels of stress and anxiety than pregnant women without this condition. Thus, it is important to identify effective interventions to help pregnant women cope with the additional stress and anxiety associated with pregnancy-related complications.AimThis integrative review aimed to synthesise evidence on the effects of educational interventions for pregnant women with gestational diabetes mellitus regarding knowledge, self-efficacy, self-care behaviour, anxiety, depression, and birth outcomes.MethodsAn integrative review of articles published between 2009 and 2024, written in English and Arabic. The review followed the Whittemore and Knafl’s 5-stage process framework.ResultsFrom the 922 abstracts identified using search terms, 16 articles were eligible for this review. Psychoeducational interventions were provided for (1) informational support: information about gestational diabetes mellitus, diabetes mellitus, blood glucose monitoring, exercise management, diet management, and stress; (2) motivational support: setting individual goals, enhancing health behaviours, and motivational messages; (3) emotional support: expression of feelings, enforcement of self-management, and sharing of experiences; and (4) relaxation techniques: breathing exercises, meditation, and mindfulness. In this review, only two studies entirely focused on reducing stress and anxiety through cognitive-behavioural stress management training and mindfulness training. The effects of the interventions on self-efficacy, knowledge, depression, anxiety, and birthing outcomes were inconsistent due to variations in intervention designs and duration. However, consistent positive outcomes were found in self-care behaviours.ConclusionThis integrative review found informational and motivational support were frequently used by pregnant women. In contrast, emotional support and relaxation techniques were rarely used. Psychoeducational interventions may enhance self-care behaviours, improve self-efficacy, and reduce stress and depression for women with gestational diabetes mellitus. Nurses and midwives play an essential role in providing holistic care through comprehensive psychoeducational interventions for pregnant women.

Vaccine decision-making among pregnant women: a protocol for a cross-sectional mixed-method study in Brazil, Ghana, Kenya and Pakistan

Maternal immunization is a critical strategy to prevent both maternal and infant morbidity and mortality from several infectious diseases. When the first COVID-19 vaccines became available during the pandemic, there was mixed messaging and confusion amongst the broader public and among those associated with health care systems about the recommendations for COVID-19 vaccinations in pregnancy in many countries. A multi-country, mixed-methods study is being undertaken to describe how vaccine decision-making occurs amongst pregnant and postpartum women, with a focus on COVID-19 vaccines. The study is being conducted in Brazil, Ghana, Kenya, and Pakistan. In each country, participants are being recruited from either 2 or 3 maternity hospitals and/or clinics that represent a diverse population in terms of socio-economic and urban/rural status. Data collection includes cross-sectional surveys in pregnant women and semi-structured in-depth interviews with both pregnant and postpartum women. The instruments were designed to identify attitudinal, behavioral, and social correlates of vaccine uptake during and after pregnancy, including the decision-making process related to COVID-19 vaccines, and constructs such as risk perception, self-efficacy, vaccine intentions, and social norms. The aim is to recruit 400 participants for the survey and 50 for the interviews in each country. Qualitative data will be analyzed using a grounded theory approach. Quantitative data will be analyzed using descriptive statistics, latent variable analysis, and prediction modelling. Both the quantitative and qualitative data will be used to explore differences in attitudes and behaviors around maternal immunization across pregnancy trimesters and the postpartum period among and within countries. Each country has planned dissemination activities to share the study findings with relevant stakeholders in the communities from which the data is collected and to conduct country-specific secondary analyses.

Preeclampsia Risk in Bali, Indonesia: The Role of Maternal Body Mass Index (BMI) and Gestational Weight Gain (GWG)

Background: Preeclampsia, a hypertensive disorder of pregnancy, significantly contributes to maternal and infant mortality and morbidity globally, including in Indonesia. Pre-pregnancy obesity and excessive gestational weight gain (GWG) are established risk factors for preeclampsia. This study investigated the association between pre-pregnancy body mass index (BMI) and GWG with the incidence of preeclampsia in Bali, Indonesia. Methods: A case-control study was conducted at a Maternal Hospital in Bali, Indonesia, from May 2023 to May 2024. The study included 429 pregnant women: 143 with preeclampsia (cases) and 286 without (controls). Data were collected from medical records. BMI was categorized using Asia-Pacific criteria, and GWG was assessed based on the 2009 Institute of Medicine (IOM) guidelines. Logistic regression analysis was performed to determine the associations, adjusting for maternal age, education, and occupation. Results: Obesity class II (BMI ≥ 30 kg/m²) and obesity class I (BMI 25.0-29.9 kg/m²) were significantly associated with an increased risk of preeclampsia, with adjusted odds ratios (AOR) of 2.90 (95% CI: 1.19-7.08) and 2.78 (95% CI: 1.60-4.81), respectively, compared to women with normal weight. Excessive GWG was also significantly associated with preeclampsia (AOR 2.53; 95% CI: 1.48-4.33) compared to adequate GWG. Conclusion: Maternal obesity and excessive GWG are significant risk factors for preeclampsia in Bali, Indonesia. These findings underscore the importance of pre-pregnancy counseling and interventions to manage weight and promote healthy GWG to reduce the burden of preeclampsia.

Maternal and infant outcomes in women with sickle cell disease: a matched cohort study

ObjectiveWomen with sickle cell disease (SCD) have adverse maternal and infant outcomes. Our aim was to determine whether the outcomes of SCD mothers and their infants differed from African or...

New Strides in Prevention of Malaria during Pregnancy Present Multitudinous Opportunities.

Pregnant women are at a higher risk of developing complications from malaria, a mosquito-borne disease caused by Plasmodium parasites, resulting in considerable maternal and infant morbidity and mortality. Malaria in pregnancy causes unfavorable and life-threatening outcomes for both the mother and fetus not limited to maternal anemia, hypoglycaemia, cerebral malaria, pulmonary edema, and puerperal sepsis. WHO recommends wide-ranging strategies for this detrimental but preventable disease; however, numerous challenges persist in ensuring high uptake of preventive therapies, effective usage of insecticide-treated bed nets, and early initiation and optimal antenatal care coverage for pregnant women. This work distils recent global advances in preventive strategies for malaria in pregnancy. We discuss three mainstay interventions by WHO, viz. intermittent preventive treatment of malaria in pregnancy (IPTp), utilization and outcomes of insecticide-treated bed nets (ITNs), and headways in malaria case management using therapeutic drugs. We cover multitudinous facets of antenatal care, WHO-advised community-based delivery of IPTp (c-IPTp), intermittent screening and treatment for malaria in pregnancy (ISTp), a malaria vaccine for pregnant women, and auxiliary factors that are crucial for improving prevention outcomes. Despite the reduction in malaria globally, malaria in pregnancy remains a prevalent issue in endemic areas, which warrants strengthening of preventative strategies. This work attempts to consolidate pivotal observations of the prevention of malaria during pregnancy by highlighting key advances, priority areas, new opportunities, research gaps, and challenges that need to be addressed to ensure improved outcomes in pregnant women infected with malaria.

O PRÉ NATAL FRENTE A MORBIMORTALIDADE MATERNO INFANTIL

This study addresses the critical importance of prenatal care in reducing maternal and infant morbidity and mortality, highlighting the significance of early adherence by pregnant women to these services. Through a literature review, it was possible to identify complications associated with non-adherence to prenatal care, such as premature births, low birth weight, and the prevalence of gestational complications that can be mitigated with adequate and timely care. Among the effective strategies for the recruitment and retention of pregnant women, the role of nurses was emphasized as fundamental, utilizing techniques that include health education, the use of information technology, and interdisciplinary practices. Programs such as Rede Cegonha were also mentioned, highlighting their contribution to strengthening prenatal care, childbirth, and postpartum support. The study underscores the need for efficient public policies and ongoing research to improve prenatal services, ensuring that all pregnant women have access to effective and humane care, guaranteeing a healthy pregnancy and a safe childbirth. This work emphasizes the urgency of integrated and evidence-based approaches in prenatal care, aiming for significant improvements in maternal and infant health.