Essential pre-pregnancy and pregnancy interventions for improved maternal, newborn and child health.
Essential pre-pregnancy and pregnancy interventions for improved maternal, newborn and child health.
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DOI：
10.1186/1742-4755-11-s1-s2
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发表时间：
2014
影响因子：
3.4
通讯作者：
Bhutta ZA
中科院分区：
文献类型：
--
作者：
Lassi ZS;Mansoor T;Salam RA;Das JK;Bhutta ZA
与怀孕及其结局有关的统计数据令人震惊：每年估计有250000至280000名妇女在分娩期间死亡。不幸的是，许多妇女在怀孕期间或怀孕前得到的护理很少或根本没有。在脆弱程度严重的时期，可以有效地提供干预措施，以改善妇女及其新生儿的健康，并使她们的妊娠安全。本文综述了在未孕和妊娠期最有效的干预措施，并协同改善母亲和新生儿的结局。在孕前干预措施中，计划生育和提倡在适当的时间间隔怀孕；预防和管理包括艾滋病毒在内的性传播感染；以及围产期叶酸补充对降低孕产妇和新生儿发病率和死亡率产生了重大影响。孕期的干预措施包括：产前查访模式；铁和叶酸补充剂；破伤风免疫接种；预防和管理疟疾；预防和管理艾滋病毒和母婴传播；钙剂用于高血压；抗血小板药物(低剂量阿司匹林)用于预防先兆子痫；抗高血压药用于治疗重度高血压；管理妊娠高血压综合征/子痫；足月臀位畸形的外部头位治疗(>；36周)；处理早产、胎膜早破；意外怀孕；以及在整个连续护理过程中对妇女和儿童进行家访，已显示对减少孕产妇和新生儿发病率和死亡率的负担有最大影响。本文总结的所有干预措施都有可能提高孕产妇死亡率，并有助于在怀孕前和围产期采取更好的保健措施。
The statistics related to pregnancy and its outcomes are staggering: annually, an estimated 250000-280000 women die during childbirth. Unfortunately, a large number of women receive little or no care during or before pregnancy. At a period of critical vulnerability, interventions can be effectively delivered to improve the health of women and their newborns and also to make their pregnancy safe. This paper reviews the interventions that are most effective during preconception and pregnancy period and synergistically improve maternal and neonatal outcomes. Among pre-pregnancy interventions, family planning and advocating pregnancies at appropriate intervals; prevention and management of sexually transmitted infections including HIV; and peri-conceptual folic-acid supplementation have shown significant impact on reducing maternal and neonatal morbidity and mortality. During pregnancy, interventions including antenatal care visit model; iron and folic acid supplementation; tetanus Immunisation; prevention and management of malaria; prevention and management of HIV and PMTCT; calcium for hypertension; anti-Platelet agents (low dose aspirin) for prevention of Pre-eclampsia; anti-hypertensives for treating severe hypertension; management of pregnancy-induced hypertension/eclampsia; external cephalic version for breech presentation at term (>36 weeks); management of preterm, premature rupture of membranes; management of unintended pregnancy; and home visits for women and children across the continuum of care have shown maximum impact on reducing the burden of maternal and newborn morbidity and mortality. All of the interventions summarized in this paper have the potential to improve maternal mortality rates and also contribute to better health care practices during preconception and periconception period.