World Library  
Flag as Inappropriate
Email this Article

Maternal health

Article Id: WHEBN0008053575
Reproduction Date:

Title: Maternal health  
Author: World Heritage Encyclopedia
Language: English
Subject: Reproductive Health Supplies Coalition, Reproductive life plan, Obstetrics, Assisted reproductive technology, Health in China
Collection: Maternal Health, Obstetrics, Sexual Health, Women's Health
Publisher: World Heritage Encyclopedia

Maternal health

Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and mortality.[1]

Preconception care can include education, health promotion, screening and other interventions among women of reproductive age to reduce risk factors that might affect future pregnancies. The goal of prenatal care is to detect any potential complications of pregnancy early, to prevent them if possible, and to direct the woman to appropriate specialist medical services as appropriate. Postnatal care issues include recovery from childbirth, concerns about newborn care, nutrition, breastfeeding, and family planning.


  • Determinants 1
    • Poverty/access to healthcare 1.1
    • HIV/AIDS 1.2
    • Maternal weight 1.3
    • Oral health 1.4
      • Benefits and effects 1.4.1
      • Collaboration and education 1.4.2
  • Effects on child health and development 2
    • Prenatal health 2.1
    • Childbirth 2.2
    • Postpartum period 2.3
  • Long-term effects for the mother 3
  • Global Situation 4
  • Proposed solutions 5
  • See also 6
  • References 7
  • External links 8


Poverty/access to healthcare

The risk for maternal death (during pregnancy or childbirth) in sub-Saharan Africa is 175 times higher than in developed countries, and risk for pregnancy-related illnesses and negative consequences after birth is even higher. Poverty, maternal health, and outcomes for the child are all interconnected. Neonatal deaths in developing countries account for 98% of worldwide yearly neonatal deaths.[2] That being said, poverty is detrimental to the health of both mother and child.

Women living in poverty-stricken areas are more likely to be obese and engage in unhealthy behaviors such as cigarette smoking and drug use, are less likely to engage in or even have access to legitimate prenatal care, and are at a significantly higher risk for adverse outcomes for both the mother and child.[3] A study conducted in Kenya observed that common maternal health problems in poverty-stricken areas include hemorrhaging, anemia, hypertension, malaria, placenta retention, premature labor, prolonged/complicated labor, and pre-eclampsia.[4]

Generally, adequate prenatal care encompasses medical care and educational, social, and nutritional services during pregnancy.[5] Although there are a variety of reasons women choose not to engage in proper prenatal care, 71% of low-income women in a US national study had difficulties getting access to prenatal care when they sought it out.[5] Additionally, immigrants and Hispanic women are at higher risk than white or black women for receiving little to no prenatal care, where level of education is also an indicator (since education and race are correlated). Adolescents are least likely to receive any prenatal care at all. Throughout several studies, women and adolescents ranked inadequate finances and lack of transportation as the most common barriers to receiving proper prenatal care.[6]

Income is strongly correlated with quality of prenatal care.[6] Sometimes, proximity to healthcare facilities and access to transportation have significant effects on whether or not women have access to prenatal care. An analysis conducted on maternal healthcare services in Mali found that women who lived in rural areas, far away from healthcare facilities were less likely to receive prenatal care than those who lived in urban areas. Furthermore, researchers found an even stronger relationship between lack of transportation and prenatal and delivery care.[7] In addition to proximity being a predictor of prenatal care access, Materia and colleagues found similar results for proximity and antenatal care in rural Ethiopa.[8]


Maternal HIV rates vary around the world, ranging from 1% to 40%, with African and Asian countries having the highest rates.[9] HIV/AIDS can be transmitted to the offspring during the prenatal period, childbirth, or breastfeeding. If a mother is infected with the HIV/AIDS virus, there is a 25% chance that she will pass on the virus to her offspring if she does not receive proper treatment during pregnancy; on the other hand, if a mother is treated during her pregnancy, there is a 98% chance that her baby will not become infected.[10]

According to

  • "5. Improve maternal health". Millennium Development Goals. UNICEF. 
  • "Maternal Health". World Health Organization. 
  • WHO Making Pregnancy Safer Country profile on maternal and newborn health

External links

  1. ^ WHO Maternal Health
  2. ^ Filippi, Veronique; et al. (28 October 2006). "Maternal health in poor countries: the broader context and a call for action". The Lancet 368: 1535–1541.  
  3. ^ Timmermans, Sarah; Bonsel, G.J., Steegers-Theunissen, R.P.M., Mackenbach, J.P., Steyerberg, E.W., Raat, H., Verbrugh, H.A., Tiemeier, H.W., Hofman, A., Birnie, E., Looman, C.W.N., Jaddoe, V.W.V., Steegers, E.A.P. (February 2011). "Individual accumulation of heterogeneous risks explains perinatal inequalities within deprived neighbourhoods". European Journal of Epidemiology 26 (2): 165–180.  
  4. ^ Izugbara, Chimaraoke; Ngilangwa, David (2010). "Women, poverty and adverse maternal outcomes in Nairobi, Kenya". BMC Women's Health 10 (33).  
  5. ^ a b Alexander, Greg; Korenbrot, C.C. (Spring 1995). "The Role of Prenatal Care in Preventing Low Birth Weight". The Future of Children. Low Birth Weight 5 (1): 103–120.  
  6. ^ a b Curry, Mary Ann (1990). "Factors Associated with Inadequate Prenatal Care". Journal of Community Health Nursing 7 (4): 245–252.  
  7. ^ Gage, Anastasia (2007). "Barriers to the utilization of maternal health care in rural Mali". Social Science & Medicine 65: 1666–1682.  
  8. ^ Materia, E.; et al. (September 1993). "A Community Survey on Maternal and Child Health Services Utilization in Rural Ethiopia". European Journal of Epidemiology 9 (9): 511–516.  
  9. ^ a b McIntyre, James (May 2005). "Maternal Health and HIV". Reproductive Health Matters 13 (25): 129–135.  
  10. ^ a b "HIV/AIDS During Pregnancy". American Pregnancy Association. Retrieved 17 October 2013. 
  11. ^ UNICEF. (2013). The state of the world's children 2013. Geneva, SWIT: UNICEF. cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  12. ^ Toure, K. & others. (2012, in press). Positioning women's and children's health in African union policy-making: A policy analysis. Global Health. cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  13. ^ a b c d McIntyre, James; Gray, Glenda (26 January 2002). "What Can We Do to Reduce Mother to Child Transmission of HIV?". British Medical Journal 324 (7331): 218–221.  
  14. ^ Simmons, D. Diabetes and obesity in pregnancy. Best Practice and Research, Clinical Obstetrics and Gynecology, 25, 2011, 25-36, cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  15. ^ Nodine, P.M., & Hastings-Tolsma, M. (2012). Maternal obesity: Improving pregnancy outcomes. MCN American Journal of Maternal Child Nursing, 37, 110-115, cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  16. ^ Chu, Susan Y.; Callaghan, W.M.; Kim, S.Y.; Schmid, C.H.; Lau, J.; England, L.J.; Dietz, P.M. (August 2007). "Maternal Obesity and Risk of Gestational Diabetes Mellitus". Diabetes Care 30 (8): 2070–2076.  
  17. ^ Glazer, Nicole L.; Hendrickson, A.F.; Schellenbaum, G.D.; Mueller, B.A. (November 2004). "Weight Change and the Risk of Gestational Diabetes in Obese Women". Epidemiology 15 (6): 733–737.  
  18. ^ a b c d e National Institute of Dental and Craniofacial Research (2000). Oral Health in America: A Report of the Surgeon General. Rockville MD: U.S. Department of Health and Human Services. 
  19. ^ a b c d "Oral Health During Pregnancy and Childhood: Evidence-based Guidelines for Health Professionals" (PDF). California Dental Association. 2010. 
  20. ^ a b c Brown A. 2008. Access to Oral Health Care During the Prenatal Period: A Policy Brief. Washington, DC: National Maternal and Child Oral Health Resource Center
  21. ^ "Partnership Between Private Practice Providers and Hospitals Enhances Access to Comprehensive Dental Care for Underserved, Low-Income Pregnant Women". Agency for Healthcare Research and Quality. 2013-02-27. Retrieved 2013-05-13. 
  22. ^ a b c d Oral Health Care During Pregnancy Expert Workgroup. 2012. Oral Health Care During Pregnancy: A National Consensus Statement—Summary of an Expert Workgroup Meeting. Washington, DC: National Maternal and Child Oral Health Resource Center.
  23. ^ a b c d Boggess KA, Edelstein BL (September 2006). "Oral health in women during preconception and pregnancy: implications for birth outcomes and infant oral health". Matern Child Health J 10 (5 Suppl): S169–74.  
  24. ^ Boggess KA, Beck JD, Murtha AP, Moss K, Offenbacher S (May 2006). "Maternal periodontal disease in early pregnancy and risk for a small-for-gestational-age infant". Am. J. Obstet. Gynecol. 194 (5): 1316–22.  
  25. ^ Boggess KA (April 2008). "Maternal oral health in pregnancy". Obstet Gynecol 111 (4): 976–86.  
  26. ^ Hurt, H.; Brodsky, N.L.; Roth, H.; Malmud, F.; Giannetta, J.M. (2005). "School performance of children with gestational cocaine exposure". Neurotoxicology and Teratology 27: 203–211.  
  27. ^ a b c d e f g Santrock, John W. (2013). Life-Span Development (14th edition). New York, NY: McGraw Hill. pp. 82–83.  
  28. ^ Crijns, H.J., & others. (2012, in press). Prescriptive contraceptive use among isotretinoin users in the Netherlands in comparison with non-users: A drug utilization study. Pharmacoepidemiology and Drug Safety. cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  29. ^ Koren, G., Nordeng, H. (2012, in press). Antidepressant use during pregnancy: The benefit-risk ratio. American Journal of Obstetrics and Gynecology. cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  30. ^ Bennett, S.A.; Bagot, C.N.; Arya, R. (2012). "Pregnancy loss and thrombophilia: The elusive link". British Journal of Hematology. 
  31. ^ Marret, S.; others (2010). "Prenatal low-dose aspirin and low-dose aspirin and neurobehavioral outcomes of children born very preterm". Pediatrics 125: e29-e34.  
  32. ^ Blandthorn, J.; Forster, D.A.; Love, V. (2011). "Neonatal and maternal outcomes following maternal use of buprenophine or methadone during pregnancy: Findings of a retrospective audit". Women and Birth 24: 32–39.  
  33. ^ Field, T.M. (2007) The amazing infant. Malden, MA. Blackwell. cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  34. ^ Mayer, K.D., & Zang. (2009). Short- and long-term effects of cocaine abuse during pregnancy on heart development. Therapeutic Advances in Cardiovascular Disease, 3, 7-16. cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  35. ^ Richardson, G.A., Goldschmidt, L., Leech, S., & Williford, J. (2011). Prenatal cocaine exposure: Effects on mother- and teacher-rated behavior problems and growth in school-aged children. Neurotoxicology and Teratology, 33, 69-77. cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  36. ^ Piper, B.J., & others. (2011). Abnormalities in parentally rated executive function in metamphetamine/polysubstance exposed children. Pharmacology, Biochemistry, and Behavior, 98, 432-439. cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  37. ^ Goldschmidt, L.; others (2008). "Prenatal marijuana exposure and intelligence test performance at age 6". Journal of the American Academy of Child and Adolescent Psychiatry 47: 254–263.  
  38. ^ Abbott, L.C.; Winzer-Sehran, U.H. (2012). "Smoking during pregnancy: Lessons learned from epidemiological studies and experimental studies using animals". Critical Reviews in Toxicology 42: 279–303.  
  39. ^ Antonopoulos, C.; others (2011). "Maternal smoking during pregnancy and childhood lymphoma: a meta-analysis". International Journal of Cancer 129: 2694–2703.  
  40. ^ Cheng, D.; others (2011). "Alcohol consumption during pregnancy: Prevalence and provider assessment". Obstetrics and Gynecology 117 (2,Pt. 2): 212–217.  
  41. ^ Paintner, A.; Williams, A.D., Burd, L. (2012). "Fetal alcohol spectrum disorders- implications for child neurology". Journal of Child Neurology 27 (2): 258–263.  
  42. ^ Paintner, A.; Williams, A. D.; Burd, L. (2012). "Fetal Alcohol Spectrum Disorders--Implications for Child Neurology, Part 2: Diagnosis and Management". Journal of Child Neurology 27 (3): 355–362.  
  43. ^ Pettitt, D.J.; others (3 February 1983). "Excessive obesity in offspring of Pima Indian women with diabetes during pregnancy". New England Journal of Medicine 308 (5): 242–245.  
  44. ^ Dabelea, D.; others (1998). "Increasing prevalence of Type II diabetes in American Indian children". Diabetologia 41: 904–910.  
  45. ^ Li, J.M., Chen, Y.R., Li, X.T., & Xu,W.C. (2011). Screening of Herpes simplex virus 2 infection among pregnant women in China. Journal of Dermatology, 38, 120-124. cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  46. ^ Nigro, G., & others. (2011). Role of the infections in recurrent spontaneous abortion. Journal of Maternal-Fetal and Neonatal Medicine, 24, 983-989. cited in Santrock, John W. (14th ed.). Life-Span Development. McGraw Hill, 2013.
  47. ^ a b Hollander, D. (September 2000). "Most Infant HIV Infection from Breast Milk Occurs within Six Weeks of Birth". International Family Planning Perspectives 26 (3): 141.  
  48. ^ a b c Stuebe, A.M.; Schwarz, E.G. (2010). "The risks and benefits of infant feeding practices for women and their children". Journal of Perinatology 30: 155–162.  
  49. ^ a b c UNICEF Maternal Health
  50. ^ World Health Organization (2005). "World Health Report 2005: make every mother and child count". Geneva: WHO. 
  51. ^ "Most Maternal Deaths in Sub-Saharan Africa Could Be Avoided". Science Daily. 2 March 2010. 
  52. ^ Maternal Health Task Force
  53. ^ "Maternal Deaths Decline Sharply Across the Globe". New York Times. 13 April 2010. 
  54. ^ "Maternal deaths worldwide drop by third". World Health Organization. 15 September 2010. 
  55. ^ "Evaluation Findings: Support to traditional birth attendants" (PDF). United Nations Population Fund. 1996. 
  56. ^ Country Comparison: Maternal Mortality Rate in The CIA World Factbook. Date of Information: 2010
  57. ^ Garret, Laurie (January–February 2007). "The Challenge of Global Health" (PDF). Foreign Affairs 86 (1): 14–38. :33
  58. ^ Garret 2007, p. 32
  59. ^ "Maternal mortality ratio per 100,000 live births by WHO region, 1990–2008". World Health Organization. 
  60. ^ Global Health Council: Women's Health
  61. ^ UNFPA: "Creating Good CARMMA for African Mothers"
  62. ^ United Nations: "Investing in the health of Africa’s mothers"
  63. ^ Jakob Engel, Jonathan Glennie, Shiva Raj Adhikari, Sanju Wagle Bhattarai, Devi Prasad Prasai and Fiona Samuels, March 2014, Nepal's Story, Understanding improvements in maternal health, http://www.developmentprogress.orgs/
  64. ^ UN HEALTH AGENCIES: "Maternal deaths worldwide drop by a third"
  65. ^ De Brouwere V, Tonglet R, Van Lerberghe W (October 1998). "Strategies for reducing maternal mortality in developing countries: what can we learn from the history of the industrialized West?". Trop. Med. Int. Health 3 (10): 771–82.  
  66. ^ "Maternal Deaths Decline Sharply Across the Globe". New York Times. 14 April 2010. 
  67. ^ World Health Organization and UNICEF (2010). "Countdown to 2015 decade report (2000–2010): taking stock of maternal, newborn and child survival" (PDF). Geneva: WHO and UNICEF. 


See also

Increasing contraceptive usage and family planning also improves maternal health through reduction in numbers of higher risk pregnancies. In Nepal a strong emphasis was placed on providing family planning to rural regions and it was shown to be effective.[66] Madagascar saw a dramatic increase in contraceptive use after instituting a nationwide family planning program, the rate of contraceptive use increased from 5.1% in 1992 to 29% in 2008.[67]

Developed countries had rates of maternal mortality similar to those of developing countries until the early 20th century, therefore several lessons can be learned from the west. During the 19th century Sweden had high levels of maternal mortality, and there was a strong support within the country to reduce mortality rate to fewer than 300 per 100,000 live births. The Swedish government began public health initiatives to train enough midwives to attend all births. This approach was also later used by Norway, Denmark, and the Netherlands who also experienced similar successes.[65]

"Maternal deaths are both caused by poverty and are a cause of it. The costs of childbirth can quickly exhaust a family’s income, bringing with it even more financial hardship."

Improving maternal health is the 5th of the 8 United Nations' Millennium Development Goals (MDGs), targeting a reduction in the number of women dying during pregnancy and childbirth by three quarters by 2015, notably by increasing the usage of skilled birth attendants, contraception and family planning.[62] The current decline of maternal deaths is only half of what is necessary to achieve this goal, and in several regions such as Sub-Saharan Africa the maternal mortality rate is actually increasing. However, one country that may meet their MDG 5 is Nepal, which has it appears reduced its maternal mortality by more than 50% since the early 1990s.[63] Decreasing the rates of maternal mortality and morbidity in developing countries is important because poor maternal health is both an indicator and a cause of extreme poverty. According to Tamar Manuelyan Atinc, Vice President for Human Development at the World Bank:[64]

[61] The

Proposed solutions

Worldwide, the Maternal Mortality Ratio (MMR) has decreased, with South-East Asia seeing the most dramatic decrease of 59% and Africa seeing a decline of 27%. There are no regions that are on track to meet the Millennium Development Goal of decreasing maternal mortality by 75% by the year 2015.[59]

According to Garret, increasing maternal survival, along with life expectancy, is an important goal for the world health community, as they show that other health issues are also improving. If these areas improve, disease-specific improvements are also better able to positively impact populations.[58]

Maternal mortality data is said to be an important indicator of overall health system quality because pregnant women survive in sanitary, safe, well-staffed and stocked facilities. If new mothers are thriving, it indicates that the health care system is doing its job. If not, problems likely exist.[57]

The U.S. maternal mortality a "sentinel event", and uses it to assess the quality of a health care system.

Maternal Mortality Rate worldwide, as defined by the number of maternal deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management, excluding accidental or incidental causes.[56]

Global Situation

Breastfeeding provides women with several long-term benefits. Women who breastfeed experience better glucose levels, lipid metabolism, and blood pressure, and lose pregnancy weight faster than those who do not. Additionally, women who breastfeed experience lower rates of breast cancer, ovarian cancer, and type 2 diabetes.[48] However, it is important to keep in mind that breastfeeding provides substantial benefits to women who are not infected with HIV. In countries where HIV/AIDS rates are high, such as South Africa and Kenya, the virus is a leading cause of maternal mortality, especially in mothers who breastfeed.[13] A complication is that many HIV-infected mothers cannot afford formula, and thus have no way of preventing transmission to the child through breast milk or avoiding health risks for themselves.[47] In cases like this, mothers have no choice but to breastfeed their infants regardless of their knowledge of the harmful effects.

[55] Almost 50% of the births in developing countries still take place without a

Maternal health problems also include complications from childbirth that do not result in death. For every woman that dies during childbirth, approximately 20 suffer from infection, injury, or disability[54]

Although high-quality, accessible health care has made maternal death a rare event in developed countries, where only 1% of maternal deaths occur, these complications can often be fatal in the developing world because single most important intervention for safe motherhood is to make sure that a trained provider with midwifery skills is present at every birth, that transport is available to referral services, and that quality emergency obstetric care is available.[49] In 2008 342,900 women died while pregnant or from childbirth worldwide.[52] Although a high number, this was a significant drop from 1980, when 526,300 women died from the same causes. This improvement was caused by lower pregnancy rates in some countries; higher income, which improves nutrition and access to health care; more education for women; and the increasing availability of “skilled birth attendants” — people with training in basic and emergency obstetric care — to help women give birth. The situation was especially led by improvements in large countries like India and China, which helped to drive down the overall death rates. In India, the government started paying for prenatal and delivery care to ensure access, and saw successes in reducing maternal mortality, so much so that India is cited as the major reason for the decreasing global rates of maternal mortality.[53]

In many developing countries, World Health Report 2005, poor maternal conditions account for the fourth leading cause of death for women worldwide, after HIV/AIDS, malaria, and tuberculosis.[50] Most maternal deaths and injuries are caused by biological processes, not from disease, which can be prevented and have been largely eradicated in the developed world — such as postpartum hemorrhaging, which causes 34% of maternal deaths in the developing world but only 13% of maternal deaths in developed countries.[51]

Maternal health clinic in Afghanistan (source: Merlin)

Long-term effects for the mother

[48], rotavirus, respiratory syncytial virus and herpes simplex virus-1, as well as gastrointestinal and lower respiratory tract infections and otitis media. Lower rates of infant mortality are observed in breastfed babies in addition to lower rates of sudden infant death syndrome (SIDS). Decreases in obesity and diseases such as childhood metabolic disease, asthma, atopic dermatitis, Type I diabetes, and childhood cancers are also seen in children who are breastfed.Staphylococcus epidermidis, group B streptococci, Haemophilus influenza, Streptococcus pneunoniae, Vibrio cholerae, Escherichia coli, Giardia lamblia Infants who are breastfed by healthy mothers (not infected with HIV/AIDS) are less prone to infections such as [48] During the

Postpartum period

Genital herpes is passed to the offspring through the birth canal during delivery.[45][46] In pregnancies where the mother is infected with the virus, 25% of babies delivered through an infected birth canal become brain damaged, and 1/3 die.[27] HIV/AIDS can also be transmitted during childbirth through contact with the mother's body fluids.[27] Mothers in developed countries may often elect to undergo a caesarean section to reduce the risk of transmitting the virus through the birth canal, but this option is not always available in developing countries.[13]


Because the embryo or fetus's nutrition is based on maternal protein, vitamin, mineral, and total caloric intake, infants born to malnourished mothers are more likely to exhibit malformations. Additionally, maternal stress can affect the fetus both directly and indirectly. When a mother is under stress, physiological changes occur in the body that could harm the developing fetus. Additionally, the mother is more likely to engage in behaviors that could negatively affect the fetus, such as tobacco smoking, drug use, and alcohol abuse.[27]

Gestational diabetes is directly linked with obesity in offspring through adolescence.[43] Additionally, children whose mothers had diabetes are more likely to develop Type II diabetes.[44] Mothers who have gestational diabetes have a high chance of giving birth to very large infants (10 pounds or more).[27]

Although HIV/AIDS can be transmitted to offspring at different times, the most common time that mothers pass on the virus is during pregnancy.[10] During the perinatal period, the embryo/fetus can contract the virus through the placenta.[27]

Although alcohol use in careful moderation (one to two servings a few days a week) during pregnancy are not generally known to cause fetal alcohol spectrum disorder (FASD), the US Surgeon General advises against the consumption of alcohol at all during pregnancy.[40] Excessive alcohol use during pregnancy can cause FASD, which commonly consist of physical and cognitive abnormalities in the child such as facial deformities, defective limbs, face, and heart, learning problems, below average intelligence, and intellectual disability (ID).[41][42]

Cigarette smoking during pregnancy can have a multitude of detrimental effects on the health and development of the offspring. Common results of smoking during pregnancy include pre-term births, low birth weights, fetal and neonatal deaths, respiratory problems, and sudden infant death syndrome (SIDS),[27] as well as increased risk for cognitive impairment, attention deficit hyperactivity disorder (ADHD) and other behavioral problems.[38] Also, in a study published in the International Journal of Cancer, children whose mothers smoked during pregnancy experienced a 22% risk increase for non-Hodgkin lymphoma.[39]

Newborns whose mothers use heroin during the gestational period often exhibit withdrawal symptoms at birth and are more likely to have attention problems and health issues as they grow up.[32] Use of stimulants like methamphetamine and cocaine during pregnancy are linked to a number of problems for the child such as low birth weight and small head circumference and motor and cognitive developmental delays, as well as behavioral problems across childhood.[33][34][35][36] The American Academy of Child and Adolescent Psychiatry found that 6 year-olds whose mothers had smoked during pregnancy scored lower on an intelligence test than children whose mothers had not.[37]

Prescription drugs taken during pregnancy such as streptomycin, tetracycline, some antidepressants, progestin, synthetic estrogen, and Accutane,[28][29] as well as over-the-counter drugs such as diet pills, can result in teratogenic outcomes for the developing embryo/fetus. Additionally, high dosages of aspirin are known to lead to maternal and fetal bleeding, although low-dose aspirin is usually not harmful.[30][31]

A teratogen is "any agent that can potentially cause a birth defect or negatively alter cognitive and behavioral outcomes." Dose, genetic susceptibility, and time of exposure are all factors for the extent of the effect of a teratogen on an embryo or fetus.[27]

Poverty, malnutrition, and substance abuse may contribute to impaired cognitive, motor, and behavioral problems across childhood.[26] In other words, if a mother is not in optimal health during the prenatal period (the time while she is pregnant) and/or the fetus is exposed to teratogen(s), the child is more likely to experience health or developmental difficulties, or death. The environment in which the mother provides for the embryo/fetus is critical to its wellbeing well after gestation and birth.

Prenatal health

Effects on child health and development

The significance of oral health is apparent, however, many women do not receive dental services before, during, and after pregnancy, even with obvious signs of oral disease.[22] There are several factors at play regarding pregnant women not seeking dental care, including the role of the health care system and disposition of the woman herself. There is a common misconception that it is not safe to obtain dental services while pregnant. Many prenatal and oral health providers have limited knowledge about the impact and safety of delivering dental services; hence they might delay or withhold treatment during pregnancy.[19] Moreover, some prenatal providers are not aware of the importance of oral health on overall general health, thus failing to refer their patients to dental providers. [22] First and foremost, the misconception regarding the impact of dental services while a woman is pregnant needs to be purged. There is a consensus that prevention, diagnosis, and treatment of oral diseases are highly beneficial and can be performed on pregnant women having no added fetal or maternal risk when compared to the risk of providing no oral care.[22] Equally important is establishing collaboration among clinicians, especially maternal health providers, with other dental providers. There should be coordination among general health and oral health providers, especially because of the interdependence of the two fields.[18] Thus, it is imperative to educate and train health providers of the significance of oral health, designing methods to incorporate in their respective practices. Providers most provide education to pregnant women addressing the importance of oral health, because these women ultimately control the fate of themselves and their offspring. For example, providers can illustrate to mothers how to reduce cavities by wiping down the gums of their children with a soft cloth after breastfeeding or bottle-feeding.[19] Bestowing knowledge and practical applications of good oral health maintenance measures to mothers can help improve overall health of the mother and child. There are still other factors in play when analyzing the low use of dental services by pregnant women, particularly prevalent among ethnic and racial minorities. A major factor is the lack of insurance and or access to dental services.[18] For this reason, more data needs to be collected and analyzed so that programs are set up to effectively to reach all segments of the population.

Collaboration and education

Another notable oral disease pertinent to maternal child health is dental caries. Dental caries is the process of tooth decay, and the development of what is commonly known as cavities.[23] Dental carries are transmitted from mother to child vertically; colonization of cariogenic bacteria primarily occurs from mother to child through saliva-sharing activities. Maternal oral flora can ultimately foretell oral flora in offspring.[25] In addition, other maternal factors such as social, behavioral, and biological factors can predispose a child’s experience with tooth-decay.[23] Some of these factors include the lack of knowledge a mother possesses concerning oral health, which can influence the development of caries among her children. Compared to children whose mothers have good oral health, children whose mothers have bad oral health are five times as likely to have poor oral health.[20] Poor maintenance of oral health has profound implications on the development of children. As mentioned in the Surgeon’s General Report, oral health affects the quality of life, especially children, with respect to functional, psychological, economic, and overall emotional well-being of an individual.[18] To demonstrate the adverse effects of poor oral health, take for example the consequences a simple cavity can have on a child. First, it is painful. This might cause a child to miss school or have poor concentration, eventually compromising school performance. In addition, due to the pain, it might result in poor weight gain or growth. Also, children may exhibit reduced self-esteem because of cosmetic issues. Furthermore, it can affect language and impair speech. Impaired speech development can also result in low self-esteem. Finally, cavities although easily preventable, can pose a financial burden of a family. Public dental services are scarce and costly to individuals who lack dental insurance. It may also result in unwarranted visits to emergency department. Poor oral health permeates into other aspects of life, posing threats to overall well-being, if not handled timely and effectively

Protection and control of oral health and diseases safeguards a woman’s health and quality of life before and during pregnancy.[22] Also, it has the potential to decrease the transmission of pathogenic bacteria that occurs from mother to child.[19] Along with pregnancy, come physiological changes for a woman. The changes, including fluctuating hormones, increase the woman’s susceptibility to oral infections such as periodontal disease. This disease impairs the body’s ability to repair and maintain soft tissues.[20] It also causes indirect damage through bacterial induction of both inflammatory and immune responses of the host.[23] During pregnancy, mild inflammation of the gums, “pregnancy gingivitis”, is quite common and if left untreated can lead to periodontal disease. There have been an increased number of studies establishing associations between, periodontal disease and negative health outcomes, which include tooth loss, cardiovascular disease, stroke, poor diabetes control, and adverse birth outcomes. For example, one such study found that moderate or severe periodontal disease early in pregnancy was associated with delivery of small-for-gestational-age infant.[24] Other studies have also found an association between periodontal disease and development of pre-eclampsia and pre-term births.[23]

Benefits and effects

Oral health has numerous implications on overall general health and the quality of life of an individual. The Surgeon General’s Report lists that various systemic diseases and conditions have oral manifestations.[18] The oral cavity serves as both a site of and a gateway entry of disease for microbial infections, which can affect general health status. In addition, some studies have demonstrated a relationship between periodontal diseases and diabetes, cardiovascular disease, stroke, and adverse pregnancy outcomes. Furthermore, the report establishes a relationship between oral health and quality of life, including functional, psychosocial, and economic indicators. Poor oral health can affect diet, nutrition, sleep, psychological status, social interaction, school, and work.

The 2000 Surgeon’s General Report stresses the interdependence of oral health on the overall health and well-being of an individual.[18] Oral health is especially essential during perinatal period and the future development of the child.[19] Proper management of oral health has benefits to both mother and child. Furthermore, lack of understanding or maintenance of good oral health for pregnant women may have adverse effects on them and their children. Hence, it is imperative to educate mothers regarding the significance of oral health. Moreover, collaboration and support among physicians across various fields, especially among family practitioners and obstetricians, is essential in addressing the concerns for maternal oral health.[20] In 2007, the Maternal Oral Health Project was developed to provide routine oral care to low-income pregnant women in Nassau County, NY. Since its inception, the program has treated more than 2,000 pregnant women, many of whom had significant gum and/or tooth problems.[21]

Maternal oral health has been shown to effect the well-being of both the mother and her unborn fetus.

Oral health

Gestational weight gain should typically fall between 11-20 pounds in order to improve outcomes for both mother and child.[14] Increased rates of hypertension, diabetes, respiratory complications, and infections are prevalent in cases of maternal obesity and can have detrimental effects on pregnancy outcomes.[15] Obesity is an extremely strong risk factor for gestational diabetes.[16] Research has found that obese mothers who lose weight (at least 10 pounds) in-between pregnancies reduce the risk of gestational diabetes during their next pregnancy, whereas mothers who gain weight actually increase their risk.[17]

Maternal weight

[9] Having HIV/AIDS while pregnant can also cause heightened health risks for the mother. A large concern for HIV-positive pregnant women is the risk of contracting tuberculosis (TB) and/or malaria, in developing countries.[13]

This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.