Journal Article

Improving pregnancy outcomes in low- and middle-income countries

Goldenberg, Robert L., Saleem, Sarah, McClure, Elizabeth M.

2018

Overview

This paper reviews the very large discrepancies in pregnancy outcomes between high, low and middle-income countries and then presents the medical causes of maternal mortality, stillbirth and neonatal mortality in low-and middle-income countries. Next, we explore the medical interventions that were associated with the very rapid and very large declines in maternal, fetal and neonatal mortality rates in the last eight decades in high-income countries. The medical interventions likely to achieve similar declines in pregnancy-related mortality in low-income countries are considered. Finally, the quality of providers and the data to be collected necessary to achieve these reductions are discussed. It is emphasized that single interventions are unlikely to achieve important reductions in pregnancy-related mortality. Instead, improving the overall quality of pregnancy-related care across the health-care system will be necessary. The conditions that cause maternal mortality also cause stillbirths and neonatal deaths. Focusing on all three mortalities together is likely to have a larger impact than focusing on one of the mortalities alone.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Abortion / Antibiotics / Births / Commentary / Continuous positive airway pressure / Developing Countries / Economic models / Etiology / Female / Gastrointestinal diseases / Health aspects / Health care reform / Hemorrhage / High income / Humans / Hypertension / Infant / Infant Mortality / Infant, Newborn / Infants / Infants (Newborn) / Low income groups / Low-middle income countries / Maternal and Child Health / Maternal Mortality / Medicine / Medicine & Public Health / Mothers / Necrosis / Neonatal mortality / Newborn babies / Nosocomial infections / Patient outcomes / Perinatal Death - prevention & control / Preeclampsia / Pregnancy / Pregnancy Outcome / Pregnant women / Public Health / Reproductive health / Reproductive Medicine / Respiratory distress syndrome / Stillbirth / Womens health