Integrated Maternal and Newborn Care Basic Skills Course ...

• All pregnant women receive at least four focused (quality) antenatal visits.
• Detection of risk factors should be modified to put the emphasis on educating the
women, men, and family members about danger signs and the actions necessary to get
timely access to maternal health services if the woman experiences a complication.
• The so-called risk factors, instead of being considered as markers or indicators of
complications, should be regarded as factors associated with complications, and their
importance for each pregnancy and childbirth should be considered on a case-by-case
basis.
• The presence of risk factors implies a need for more careful monitoring, not because
they are necessarily predictive of complications. For many of them (e.g., age), nothing
can be done to alter the risk factor. However, additional care and watchfulness may
prevent a complication from arising or enable its early detection and management.
MATERNAL CONDITIONS AFFECTING FETAL AND NEWBORN SURVIVAL
This section will discuss maternal conditions, pregnancy-related complications, and maternal
infections that have an impact on fetal and newborn health and survival.
Iron-deficiency Anemia
Figure 3.1. Signs of iron-deficiency anemia
An anemic pregnant woman has a high risk of getting
ill (because of lowered resistance to infection), of
having a low birth weight (LBW) infant with a birth
weight of less than 2500 grams, of giving birth
prematurely before 37 completed weeks of gestation,
of suffering from postpartum hemorrhage and heart
failure, and of dying. Many women are already anemic
when they become pregnant; closely spaced
pregnancies, malaria, hookworm, sickle cell anemia,
and frequent and chronic infections are some of the
causes of anemia.
Iodine Deficiency
Iodine needs increase greatly during pregnancy because iodine is essential for the development
and maturation of the fetal nervous system. Iodine deficiency in the pregnant woman has been
associated with: 1) in the fetus: abortion, stillbirth, retardation of cerebral development, and
congenital anomalies; 2) in the newborn: low birth weight, goiter, and neonatal hypothyroidism;
and 3) in the adult: goiter and complications from goiters.
Malnutrition
Maternal undernutrition during pregnancy is associated with low birth weight. Low birth weight,
in turn, has been shown to correlate with an increased incidence of the following: neonatal,
infant, and child morbidity and mortality, small head circumference, mental retardation, cerebral
palsy, learning problems/disabilities, visual and hearing defects, neurologic defects, and poor
infant growth and development.
30
Integrated maternal and newborn care
Basic skills course