Maternal Well-being Research Articles

Ohpikihâwasowin (grounding and guiding on the path to be a healthy parent): virtual adaptation of an Elders mentoring program to support maternal and child wellbeing during the COVID-19 pandemic

BackgroundThe Elders Mentoring Program (EMP) is part of a strengths-based community-based participatory research partnership with the Cree communities of Maskwacîs, Alberta, Canada. The EMP objective is to promote maternal and child health through traditional Cree teachings and support from community Elders to pregnant women and their partners. During the COVID-19 pandemic, the Elders decided to shift the program to an online format in early 2021. The Elders continued to offer mentorship to program participants virtually by Zoom and telephone, and online workshops. The objective of this study was to qualitatively explore the experiences of women that took part in the virtual EMP.MethodsWe utilized qualitative description as our method, informed by our overarching community-led research partnership. Semi-structured phone interviews were conducted by Maskwacîs research assistants (RAs) with 11 women who participated in the virtual program. Interviews were conducted between December 2021 and June 2022. The participants were asked about their perceptions of the program and its benefits. The interviews were recorded, transcribed, and coded by four RAs using thematic analysis.ResultsAlthough cultural teachings are traditionally offered in person, the shift to the virtual platform was greatly appreciated by all the women. Technology can be a useful tool for cultural teachings and language to be shared among community members when they cannot be physically together. Four main themes emerged from the data, representing the participants’ experiences, and learning through their interactions with the Elders from the EMP. The themes are: Ohpikihâwasowin (grounding and guiding on the path to be a healthy parent); Indigenous ways of healing; On the path of cultural learning; and Identity for self and baby.ConclusionThe virtual adaptation of the EMP allowed a space for Elders to offer support to women living in and out of the community to provide guidance with their pregnancies and into motherhood. The workshops and one-on-one calls allowed for cultural revitalization which is critical for Indigenous well-being. All the participants found that the teachings and interactions positively impacted their pregnancy and parenthood. Overall, the virtual program demonstrated a venue for intergenerational healing and resilience.

Single vs. multi-slice assessments of in vivo placental T2∗ measurements

IntroductionPlacental health is vital for maternal and fetal well-being, and placental T2∗ has been suggested to identify in vivo placental dysfunction prior to delivery. However, ideal regions of interest to best inform functional assessments of the placenta remain unknown. The aim of this study is to compare global and slice-wise measures of in-vivo placental T2∗ assessments. MethodsThis prospective study recruited pregnant people with singleton pregnancies between December 2017 and February 2022.3D multi-echo RF-spoiled gradient echo sequences were acquired, and placental T2∗ values were derived from global and slice-wise approaches. Statistical analyses included Pearson correlation coefficients, concordance correlation coefficients (CCC), intraclass correlation coefficients (ICC), and Bland-Altman analyses. ResultsOf 115 participants (mean gestational age, 29.25 ± 5.05 weeks), 68 were healthy controls, and 47 were high-risk pregnancies. Global and slice-wise placental T2∗ assessments for the entire cohort showed no significant difference nor for individual subgroups (healthy controls or high-risk). Pearson correlation values ranged between 0.88 and 0.99 for mean global and slice-wise placental T2∗. CCC analyses ranged from 0.88 to 0.99 for mean T2∗, and ICC analyses ranged between 0.88 and 0.99 for mean T2∗, showing a strong agreement between measurements. Bland-Altman analyses depicted T2∗ differences across coverage methods, and groups resided within the 95 % limits of agreement. DiscussionSingle-slice placental assessments offer robust, comparable T2∗ values to global assessments, with the added benefit of reducing post-processing time and SAR exposure. This supports slice-wise approaches as valid alternatives for assessing placental health in various pregnancies.

Effect of Music Therapy on Anxiety in Pregnancy: A Systematic Review of Randomized Controlled Trials.

Pregnancy can heighten anxiety levels, impacting both maternal and fetal well-being. This systematic review synthesizes evidence from 33 randomized controlled trials exploring the effects of music therapy on anxiety in pregnant women. The studies included diverse populations, ranging from women undergoing in vitro fertilization (IVF) to those facing high-risk pregnancies. Music therapy interventions varied widely, including virtual reality experiences, classical music, lullabies, and patient-selected music, administered at different pregnancy stages such as IVF treatments, elective cesarean sections, and high-risk hospitalizations. The findings consistently demonstrated that music therapy significantly reduces anxiety levels in pregnant women. Positive outcomes included reductions in both state and trait anxiety, improved pregnancy rates, and enhanced maternal-fetal parameters. Additionally, music therapy showed promise in reducing anxiety during labor, cesarean deliveries, and high-risk hospital stays. These varied interventions and their positive outcomes highlight the potential of music therapy as an effective, non-pharmacological approach to managing pregnancy-related anxiety. This review provides a comprehensive overview of the existing evidence on music therapy's efficacy in alleviating anxiety during pregnancy. It underscores the need for further research to standardize interventions and incorporate music therapy into routine prenatal care. By enhancing the overall well-being of expectant mothers, music therapy could become a valuable adjunct to conventional prenatal care practices.

Creating an intergenerational cohort of mothers and their children using administrative data from health, education and social care in England (ECHILD)

ObjectiveMaternal physical, psychological, and social risk factors extend beyond impacting maternal wellbeing to significantly influence their children. Sibling dynamics also play a crucial role in individual development, health and wellbeing. We established a national intergenerational cohort of mothers and their children using administrative health, education and social care data in England (ECHILD). ApproachWe extracted 14.5 million baby records from hospital records for births between 1997-2022 and linked 13.6 million (94.1%) of these to delivery records of 8.0 million mothers using a validated probabilistic algorithm. We then identified clusters of mothers with only-children and mothers with sibling-children by identifying livebirths linked to the same mother. ResultsThe cohort captures 87.7% of all livebirths in England and includes mothers aged up to 37 and their children. We identified 4,086,648 mother-only-child clusters and 3,957,856 mother-sibling-children clusters. Compared with only-children, children with siblings were more likely to live in more deprived areas and have younger mothers, but were less likely to be overdue births (>=42 weeks gestation), or to have very low birth weight (<1500g). Among the mother-sibling-children clusters, sibship sizes varied between 2-15, with a mean of 2.4 children per mother. The median birth interval was 3.0 years. Conclusions and ImplicationsThis national cohort of 8 million mothers and their children (including 4.1 million mother-only-child and 4.0 million mother-sibling-children clusters) linked to hospital, education and social care data is an important resource for investigating the effects of maternal exposures, sibling dynamics and their interplay on individual development, health and wellbeing.

Protecting maternal health: Strategies against HIV and malaria in pregnancy.

Maternal health remains a global priority, with particular emphasis on combating infectious diseases such as HIV and malaria during pregnancy. Despite significant progress in prevention and treatment efforts, both HIV and malaria continue to pose significant risks to maternal and fetal well-being, particularly in resource-limited settings. The prevention of mother-to-child transmission (PMTCT) programs for HIV and intermittent preventive treatment (IPTp) for malaria represent cornerstone strategies in mitigating the impact of these infections on pregnancy outcomes. PMTCT programs focus on early HIV diagnosis, antiretroviral therapy initiation, and promoting safe infant feeding practices to reduce the risk of mother-to-child transmission. Similarly, IPTp involves the administration of antimalarial medication to pregnant women in malaria-endemic regions to prevent maternal and fetal complications associated with malaria infection. Integration of HIV and malaria prevention and treatment services within existing maternal and child health programs is crucial for maximizing impact and minimizing healthcare system strain. Strengthening health systems, improving access to antenatal care services, and enhancing community engagement are essential components of comprehensive maternal health strategies. Furthermore, promoting awareness, education, and empowerment of pregnant women and communities are vital in fostering health-seeking behaviors and adherence to preventive measures against HIV and malaria. In conclusion, protecting maternal health from the dual threat of HIV and malaria requires a multifaceted approach that encompasses prevention, screening, treatment, and community engagement.

The Happy Child Program's Intersectionality: Prenatal Home Visit Frequency, Food Insecurity Risk, Symptoms of Depression, and Parental Practices in Brazilian Women Assisted during Pregnancy.

Food insecurity (FI) is a critical issue in developing countries, particularly in low-resource settings, where it can worsen women's mental health. Psychosocial factors such as low household income, limited education, multiparity, and vulnerability are linked to depressive symptoms during pregnancy. Additionally, the family environment influences parental practices, which may impact mental health. This study evaluates the association of socioeconomic factors, parental practices, FI risk, and home visit frequency with depressive symptoms in pregnant women enrolled in the Happy Child Program (Programa Criança Feliz-PCF) in the Federal District, Brazil. In this cross-sectional study, 132 pregnant women monitored by PCF from May to July 2023 were assessed using a self-administered questionnaire for socioeconomic data, the two-item Triage for Food Insecurity (TRIA) instrument for FI risk, the Scale of Parental Beliefs and Early Childhood Care Practices, and the Beck Depression Inventory-II for depressive symptoms. Most participants were multiparous (87.9%), had low income (under 200 USD/month; 80.8%), presented depressive symptoms (67.4%) and were at risk of FI (81.8%). About half demonstrated adequate parental practices (50.8%) and received four home visits per month during pregnancy (54.5%). Women who received four PCF home visits had a lower prevalence of depressive symptoms compared to those with fewer visits (PR 0.76, 95% CI 0.59-0.98). No significant association was found between FI or parental practices and depressive symptoms. These findings suggest that the PCF home-visiting program may strengthen vulnerable families, support social networks, and improve mental health during pregnancy. Additionally, the results of this study highlight the need for targeted interventions aimed at reducing food insecurity and promoting mental health during pregnancy, particularly among socially vulnerable populations. Furthermore, they reinforce the importance of expanding access to home-visiting programs as an effective strategy to improve maternal mental health and well-being, while fostering healthier prenatal environments for both mothers and their children.

Integrative microbiome and metabolome profiles reveal the impacts of periodontitis via oral-gut axis in first-trimester pregnant women

BackgroundPeriodontitis results from host-microbe dysbiosis and the resultant dysregulated immunoinflammatory response. Importantly, it closely links to numerous systemic comorbidities, and perplexingly contributes to adverse pregnancy outcomes (APOs). Currently, there are limited studies on the distal consequences of periodontitis via oral-gut axis in pregnant women. This study investigated the integrative microbiome-metabolome profiles through multi-omics approaches in first-trimester pregnant women and explored the translational potentials.MethodsWe collected samples of subgingival plaques, saliva, sera and stool from 54 Chinese pregnant women at the first trimester, including 31 maternal periodontitis (Perio) subjects and 23 Non-Perio controls. By integrating 16S rRNA sequencing, untargeted metabolomics and clinical traits, we explored the oral-gut microbial and metabolic connection resulting from periodontitis among early pregnant women.ResultsWe demonstrated a novel bacterial distinguisher Coprococcus from feces of periodontitis subjects in association with subgingival periodontopathogens, being different from other fecal genera in Lachnospiraceae family. The ratio of fecal Coprococcus to Lachnoclostridium could discriminate between Perio and Non-Perio groups as the ratio of subgingival Porphyromonas to Rothia did. Furthermore, there were differentially abundant fecal metabolic features pivotally enriched in periodontitis subjects like L-urobilin and kynurenic acid. We revealed a periodontitis-oriented integrative network cluster, which was centered with fecal Coprococcus and L-urobilin as well as serum triglyceride.ConclusionsThe current findings about the notable influence of periodontitis on fecal microbiota and metabolites in first-trimester pregnant women via oral-gut axis signify the importance and translational implications of preconceptional oral/periodontal healthcare for enhancing maternal wellbeing.

Substance Use Disorder as a Risk Factor for Postpartum Depression: A Retrospective Chart Review in a Community Hospital.

This retrospective study examines the relationship between postpartum depression (PPD) and substance use disorder (SUD) in a community hospital setting. This retrospective chart review explored the association between SUD and PPD in a community hospital. Data from January 2016 to December 2018 were extracted from electronic medical records (EPIC EMR (Epic Systems Corporation, Verona, WI)), identifying mothers with PPD (n = 99) using billing code F53.0. Substance use disorder was assessed using diagnostic codes F10-F19. Odds ratios (OR), relative risk (RR), and chi-square tests were calculated to quantify and assess the significance of the association between SUD and PPD. Ethical approval was obtained from the Institutional Review Board (IRB). Among 2,517 deliveries during the study period, 51 cases of PPD co-occurred with SUD. Mothers with SUD had a 4.3 times higher risk of PPD compared to those without SUD (OR = 4.8), highlighting a significant association. These findings emphasize the importance of screening for PPD and SUD in pregnant and postpartum women, especially in community healthcare settings where routine screening may be limited. Targeted interventions can mitigate adverse effects on maternal and infant well-being.

Subclinical Hypothyroidism and Placenta Abruption: A Dangerous Relationship During Pregnancy

This case report explores the intricate link between subclinical hypothyroidism and placenta abruption during pregnancy, emphasising the potential risks and clinical implications, through a detailed case study of a 28-year-old woman with a history of hyperthyroidism, non-compliance, and subsequent subclinical hypothyroidism, causing placenta abruption leading to intrauterine death. The report highlights the challenges in managing thyroid disorders during pregnancy. Limited Malaysian data on this association prompts a broader discussion of international findings, suggesting a correlation between subclinical hypothyroidism and adverse pregnancy outcomes. The study delves into potential mechanisms, including thyroid hormone impact on placental vascular function and the complexity added by autoimmune thyroiditis. Personalised treatments, thyroid function monitoring, and comprehensive antenatal care are emphasised for optimal pregnancy outcomes. This case underscores the need for increased awareness, proactive management, and preconception counselling to safeguard maternal and foetal well-being.

Impact of anaemia in pregnancy on maternal and fetal wellbeing in Oman: a retrospective study

Background/Aims Anaemia is associated with negative outcomes for both mothers and infants. Better understanding of its consequences could lead to improved guidelines for screening and treatment. The aim of this study was to investigate anaemia in pregnancy and adverse maternal and fetal outcomes among pregnant women in Oman. Methods This retrospective study examined the medical records of women who gave birth at a university hospital in Oman over a 3-year period. Chi-squared tests were used for data analysis. Results A total of 723 pregnant women were included, with 62.8% diagnosed with anaemia. Anaemia was significantly associated with preterm birth (P=0.037), low birth weight (P=0.009), intrauterine growth restriction (P=0.002) and postpartum heamorrhage (P=0.019). Conclusions Anaemia is a significant health concern for pregnant women in Oman. Further research will provide more data on its effects, informing targeted interventions and policy enhancements. Implications for practice Early antenatal screening, targeted iron supplementation, nutritional education, appropriate treatment and active management during birth would help address this issue.

Factors associated with pregnancy-related anxiety: a health facility-based study

Pregnancy is a critical phase for human beings, which can lead to various mental health issues, including anxiety. It is important to recognize that pregnancy-related anxiety can increase over time and should be addressed. This study aimed to explore the multifactor of pregnancy-related anxiety during the first trimester. A cross-sectional health facility-based study was conducted in four Semarang, Central Java, Indonesia public health centers. A total of 129 pregnant women were involved and identified some exposures, such as socio-demographics, nausea and vomiting during pregnancy (NVP), emotion regulation, social support, and anxiety levels. The average age of participants was 27.3 years. Their anxiety level was moderate to severe (37.2%), and 62.8% were identified as having mild anxiety. This study suggests that pregnant women who lack social support (AOR=4.105; 1.824-9.237) and emotion dysregulation (AOR=2.749; 1.244-6.075) were identified as the risk factors of maternal anxiety during the first trimester. Being employed (AOR=0.410; 0.182-0.922) protects the high anxiety during pregnancy. This study suggests that the lack of social support, including social interaction most influences pregnant women’s mental well-being. Therefore, it may be helpful to establish an intervention plan that strengthens social support to improve maternal mental well-being.

Midwives’ Knowledge, Perceptions and Practices on Utilization of the Partograph at Mbuya Nehanda Maternity Hospital

Globally, maternal death has been an issue of concern, while obstructed and prolonged labour are among the top five causes of these deaths in Africa and Zimbabwe particularly. Proper and effective utilization of the Partograph significantly helps in preventing and reducing the high numbers of birthing complications of such a nature. A Partograph is a labour monitoring chart that provides a pictorial overview of maternal and foetal well-being during the intrapartum period. The study aimed to assess the knowledge, perceptions, and practices on the utilization of the Partograph among midwives working at Mbuya Nehanda Maternity Hospital. A descriptive cross sectional design was used, and a semi-structured questionnaire was administered to 60 participants chosen using the purposive sampling technique. Data were collected and analysed using the Statistical Package for Social Sciences (SPSS version 22) and presented using charts, tables, and narration. The study identified that midwives were knowledgeable, although they had a negative attitude towards the Partograph attributed by a lack of motivation caused by the absence of support from mentors and supervisors, lack of workshops, and on-the-job training on the use of the graphical chart. Underutilization of the tool, which pointed to poor practice, was attributed to understaffing of midwives, high workload, and burnout syndrome among the labour ward midwives. These implications could lead to omissions, litigations, poor maternal service delivery, and lawsuits. Periodic workshops, symposiums, on-the-job training would go a long way in improving attitudes. The study concluded that the Partograph is a very important tool that should be effectively used in the labour ward so that complications are picked up early, thereby improving maternal outcomes. Support for the midwives, supervision, mentorship, non-monetary incentives, and increased staffing with an acceptable midwife-patient ratio of probably 1:2 would improve practice and yield a positive birthing outcome of a live and healthy mother and baby.

Exogenous oxytocin administered to induce or augment labour is positively associated with quality of observed mother-infant bonding

Oxytocin is a key hormone in the transition to motherhood. The maternal endogenous oxytocin system facilitates many physiological and biological adaptations, including breastfeeding, maternal wellbeing, and brain plasticity. Additionally, maternal endogenous oxytocin works as a finetuned orchestrator prior to, during, and after the birth of a child to support birth progression and mother-infant bonding. Exogenous oxytocin may be administered to induce or augment labour when this is not progressing naturally and is a common obstetric intervention worldwide. However, the lasting impact of these widely varying levels of systemic exogenous oxytocin on mother-infant bonding is currently unknown. This study aimed to investigate the association between exogenous oxytocin administered to induce or augment labour and quality of observed mother-infant bonding.Thirty-eight mother and infant dyads participated (mothers aged 24–48 years; infants aged 2–5 months). Mother-infant bonding quality was assessed via the Recorded Interaction Task and hospital birth records were consulted to obtain exogenous oxytocin administration data. Demographic information and possible confounding factors were collected from dyads, and salivary oxytocin concentration was measured for both mother and infant.Mother's perception of infant sleep difficulty was identified as a confounding factor for quality of mother-infant bonding. After controlling for the confounding factor, receiving exogenous oxytocin to induce or augment labour, as opposed to not, was found to be significantly positively associated with higher quality of observed mother-infant bonding (p = 0.029). These novel findings highlight the need for further exploration, both of the impact of the treatment and of the mechanisms of action of intrapartum exogenous oxytocin on the endogenous oxytocin system. It is argued that particular focus be given to investigate action on the central oxytocin receptors, and if this may play a role in subsequent mother-infant bonding outcomes. It is vital to understand the full breadth and the clinical implications of this commonplace procedure.

The Role of Physical Fitness in Emotional Well-Being and Distress during Pregnancy: The GESTAFIT Project.

Pregnancy involves various physiological, physical, and social changes that can impact the mental health of the woman, causing her to have a stressful experience. Physical fitness (PF) is postulated as a powerful marker of health in this population. Therefore, this longitudinal study examined the association of PF with maternal emotional well-being and ill-being outcomes at 16th and 34th gestational weeks (g.w.) in a sample of 158 pregnant women (32.9 ± 4.7 years old). Self-reported PF was assessed with the valid and feasible International Fitness Scale [i.e., overall PF, cardiorespiratory fitness (CRF), muscular strength, speed-agility, and flexibility]; positive and negative affect, emotional intelligence, and resilience were measured using validated questionnaires specifically designed for this purpose. The results showed that women with greater overall PF and its components showed higher positive affect and lower negative affect (all, p < 0.05); greater emotional intelligence (all, p < 0.05); and greater resilience (all, p < 0.05), with similar results both in the 16th and the 34th g.w. These findings underscore the pivotal role of PF in promoting emotional health and resilience during pregnancy, thereby highlighting the need for integrating PF enhancement strategies in prenatal care programs.

Event-related potentials and behavioral correlates of emotional recognition memory in late pregnancy.

Research on cognitive and emotional functions during pregnancy challenges the prevalent perception of cognitive decline in pregnant women. This study investigates the behavioral and neural dynamics of cognitive-affective processing in third-trimester pregnant women, comparing them with non-pregnant controls. Using a 64-channel EEG-ERP system, we recorded brain activity as participants engaged in an emotional word recognition task. This task involved initially viewing a sequence of emotional and neutral words, followed by a recognition test where participants identified each word as 'new' or 'previously seen'. Contrary to widespread beliefs about diminished recognition ability during late pregnancy, our results revealed no significant differences in error rates between groups. However, pregnant participants demonstrated slower reaction times. In terms of neural responses, pregnant women exhibited increased amplitudes in the N1, P2, and N400 ERP components, suggesting that they may require additional brain resources compared with non-pregnant individuals to process perceptual information. A significant interaction was observed between pregnancy status and the emotional valence of stimuli. Pregnant women showed heightened N1 and N400 responses to negative words, indicating increased sensitivity to stimuli potentially representing threat. This enhanced response was not observed for positive or neutral words. Furthermore, there was an amplified N1 response to 'new' words, but not to 'old' words. These findings suggest that late pregnancy is characterized by heightened responsiveness to new and particularly negative stimuli, potentially leading to a more cautious behavioral approach. Heightened vigilance and sensitivity could offer evolutionary advantages, optimizing fetal development and enhancing maternal well-being.

Relationship Between Postpartum Care Practices and Mental Health Outcomes: Understanding the Impact on Maternal Well-Being

Introduction: Postpartum depression (PPD) is a major mental health condition affecting mothers during the first year postpartum, often beginning within the initial six weeks. The purpose of the study was to assess the relationship between postpartum care practices and their effects on maternal mental health outcomes. Aim of the study: The aim of the study was to evaluate the relationship between postpartum care practices and their effects on maternal mental health outcomes. Methods: This prospective observational study included 130 postpartum women aged 18-45, recruited from the outpatient and inpatient departments of BSMMU and Dhaka Medical College, Dhaka, from July 2020 to June 2021. Women were eligible if they were within six months postpartum and provided informed consent. Data were collected through face-to-face interviews using structured questionnaires, including the EPDS and GAD-7 scales. Analysis was performed using SPSS software version 22.0. Result: The majority of patients, 83 (63.85%), are in the ≥30 age group, have completed primary school, 92 (70.77%), and are Muslim, 104 (80.00%). For pre-pregnancy BMI, 58 (44.62%) of patients had a normal BMI. Parental support was available to 111 (85.38%) of patients. Regarding mental health outcomes, 74 (56.92%) of patients scored within the normal range on the Edinburgh Postnatal Depression Scale (EPDS). Conclusion: The study concludes that comprehensive postpartum support systems are crucial for reducing maternal depression and anxiety, highlighting the need for targeted interventions and systematic screening in postpartum care to improve mental health outcomes.

Postnatal quality of care measures for mothers and newborns at home: A scoping review.

The postnatal period is one of the most critical periods in the lives of mothers and newborns. Yet, the postnatal period remains the most neglected period along the maternal health care continuum. Globally, measures assessing quality of postnatal care (PNC) often focus on care at health facility level, the provision of home-based PNC and associated quality of care measures seem largely overlooked. This scoping review aims to give an overview of the literature on measures assessing quality of PNC for mothers and newborns in a home-based setting. This review was conducted according to the Arksey and O'Malley's methodology for scoping reviews. Three electronic bibliographic databases were searched together with a grey literature search. Two reviewers independently screened the identified articles. All data on home-based PNC measures were extracted and mapped according to the 2022 World Health Organization PNC Guideline recommendations in three categories: i) maternal care, ii) newborn care, iii) health system and health promotion interventions. Several additional quality of care domains, characterizing home-based PNC, were identified: i) social and emotional empowerment, ii) assessment of the home setting, iii) early breastfeeding, iv) health education and counseling, v) personal hygiene and prevention of infections, vi) referral to health facility when necessary, vii) thermal care, viii) parent-child relationship and ix) promote economic self-sufficiency. This review illustrates that home-based PNC has a very broad spectrum of care and plays a vital role in improving maternal and newborn health and well-being. In addition, there is a clear need for more research on the optimal timing and content of home-based care in the postnatal period for maximizing its potential.

Impact of climate change on maternal health outcomes: An evidence gap map review.

Climate change poses unique challenges to maternal well-being and increases complications during pregnancy and childbirth globally. This evidence gap map (EGM) aims to identify gaps in existing knowledge and areas where further research related to climate change and its impact on maternal health is required. The following databases were searched individually from inception to present: Medline, EMBASE, and Global Health via OVID; Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost; Scopus; and organizational websites. In this EGM, we integrated 133 studies published in English, including qualitative, quantitative, reviews and grey literature that examined the impact of climate change on maternal health (women aged 15-45). We used Covidence to screen studies and Evidence for Policy and Practice Information (Eppi reviewer)/Eppi Mapper software to generate the EGM. Data extraction and qualitative appraisal of the studies was done using critical appraisal tools. The study protocol was registered in International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) # INPLASY202370085. Out of 133 included studies, forty seven studies were of high quality, seventy nine moderate equality and seven low quality. This EGM found notable gaps in the literature regarding the distribution of research across regions. We found significant research in North America (51) and Asia (40 studies). However, Africa and the Caribbean had fewer studies, highlighting potential disparities in research attention and resources. Moreover, while the impact of extreme heat emerged as a prominent factor impacting maternal well-being, there is a need for further investigation into other climate-related factors such as drought. Additionally, while preterm stillbirth and maternal mortality have gained attention, there is an overlook of malnutrition and food insecurity indicators that require attention in future research. The EGM identifies existing research gaps in climate change and maternal health. It emphasizes the need for global collaboration and targeted interventions to address disparities and inform climate-responsive policies.

Association of obesity and overweight with the risk of preeclampsia in pregnant women: an observational cohort study.

According to the World Health Organization, obesity is considered a pervasive global epidemic with significant medical and social implications. In antenatal mothers, the prevalence varies from 40% in Western countries to 12% in India which leads to life-threatening complications-preeclampsia and eclampsia. This study delves into the association between body mass index (BMI) and preeclampsia, among primi antenatal mothers with pregnancy-induced hypertension (PIH). An observational cohort (prospective) study was conducted among 150 primi antenatal mothers with pregnancy-induced hypertension in Government Headquarters Hospital, Tamil Nadu, India. Demographic data, body mass index, and pregnancy outcomes were assessed. Statistical analysis was performed using the SPSS 28.0 version. Among 150 pregnant women, 63 (42%) were overweight, and 13 (8.7%) were obese. Higher BMI was significantly associated with maternal complications, especially preeclampsia (P < 0.001). Moreover, other complications such as abruptio placenta, pulmonary edema, eclampsia, and postpartum hemorrhage were not significantly associated with BMI. The study calls attention to the persistent link between BMI and preeclampsia, emphasizing the need for comprehensive strategies aligned with the Sustainable Development Goal. Despite ongoing efforts, the study suggests a lack of substantial change in the prevalence of preeclampsia associated with increased BMI, prompting the exploration of innovative interventions to address weight-related factors during pregnancy for improved maternal and neonatal well-being.

Adipose tissue-liver cross-talk: a route to hepatic dysfunction in pregnant women with obesity.

Obesity during pregnancy has been escalating, becoming a huge problem that poses consequences not only for the health of the offspring but also for the maternal well-being. Women's adipose and hepatic tissue metabolism undergoes significant changes during the gestational period. During pregnancy, obesity is a primary instigator of steatosis, increasing the risk of non-alcholic fatty liver disease (NAFLD), now recognized under the updated nomenclature metabolic dysfunction-associated steatotic liver disease (MASLD). Pregnant women with obesity present higher levels of free fatty acids and glucose, reduction in insulin sensitivity, and adipose tissue endocrine dysregulation. Furthermore, obesity-induced modifications in clock genes and lipid-associated gene expression within adipose tissue disrupt crucial metabolic adaptations, potentially culminating in adipose tissue dysfunction. Thus, the liver experiences increased exposure to free fatty acids through the portal vein. Higher uptake of free fatty acids into the liver disrupts hepatic lipid oxidation while enhances lipogenesis, thereby predisposing to ectopic fat deposition within the liver. This review focuses on the obesity-induced changes during pregnancy in both liver and adipose tissue metabolism, elucidating how the metabolic crosstalk between these two organs can be dysregulated in pregnant women living with obesity.