Indirect causes of severe adverse maternal outcomes: a secondary analysis of the <scp>WHO</scp> Multicountry Survey on Maternal and Newborn Health

Lumbiganon, Pisake; Laopaiboon, Malinee; Intarut, Nirun; Vogel, J.P.; Souza, J.P.; Gülmezoglu, A Metin; Mori, Rintaro

doi:10.1111/1471-0528.12647

Cited by 55 publications

(68 citation statements)

References 19 publications

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“…For example, we have no information on the performance of public institutions (ie, productivity, corruption, and efficiency) at the municipal level 27 ; neither do we have information regarding proximate determinants at the individual level (ie, the presence of complications, obesity, etc.). 61 Fourth, the spatial structure selected could have influenced the estimated impacts. Nevertheless, we analyzed the robustness of our estimates by modifying this parameter and found no variation.…”

Section: Discusion and Conclusionmentioning

confidence: 99%

Government expenditure on health and maternal mortality in México: A spatial‐econometric analysis

Pérez-Pérez

Serván‐Mori²,

Nigenda

et al. 2019

Health Planning & Management

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Summary Objective To assess the relationship between government expenditure on maternal health (GE) and maternal mortality (MM) in Mexican poor population between 2000 and 2015 in the 2457 Mexican municipalities. Methods Using administrative data, we performed the analysis in three stages: First, we tested the presence of selection bias in MM. Next, we assessed the presence of spatial dependence in the incidence and severity of MM. Finally, we estimated a spatial error model considering the correction of estimates for the spatial dependence and selection bias assessed before. Results MM and GE were not randomly distributed throughout the Mexican territory; the most socially vulnerable municipalities exhibited the highest levels of MM severity but the lowest levels of GE and available human and physical resources for maternal health; the incidence of MM was independent of GE; elasticity of GE‐severity in MM was −4% (P < 0.01). Conclusions Resource allocation for maternal health must move towards a more comprehensive vision, and efforts to achieve an effective delivery of universal health services must improve, particularly regarding the most vulnerable municipalities.

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Section: Discusion and Conclusionmentioning

confidence: 99%

Government expenditure on health and maternal mortality in México: A spatial‐econometric analysis

Pérez-Pérez

Serván‐Mori²,

Nigenda

et al. 2019

Health Planning & Management

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“…One out of 10 maternal deaths can be attributed to iron deficiency anemia [41,42]. According to the conclusion of a 2015 meta-analysis, preventive iron supplementation reduced maternal anemia at term by 70%, but data about maternal death, coming from two studies only, were inconclusive [43].…”

Section: Benefits and Risks Of Iron Interventionsmentioning

confidence: 99%

Iron for Africa—Report of an Expert Workshop

et al. 2017

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Scientific experts from nine countries gathered to share their views and experience around iron interventions in Africa. Inappropriate eating habits, infections and parasitism are responsible for significant prevalence of iron deficiency, but reliable and country-comparable prevalence estimates are lacking: improvements in biomarkers and cut-offs values adapted to context of use are needed. Benefits of iron interventions on growth and development are indisputable and outweigh risks, which exist in populations with a high infectious burden. Indeed, pathogen growth may increase with enhanced available iron, calling for caution and preventive measures where malaria or other infections are prevalent. Most African countries programmatically fortify flour and supplement pregnant women, while iron deficiency in young children is rather addressed at individual level. Coverage and efficacy could improve through increased access for target populations, raised awareness and lower cost. More bioavailable iron forms, helping to decrease iron dose, or prebiotics, which both may lower risk of infections are attractive opportunities for Africa. Fortifying specific food products could be a relevant route, adapted to local context and needs of population groups while providing education and training. More globally, partnerships involving various stakeholders are encouraged, that could tackle all aspects of the issue.

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“…It is important not to miss women with severe anemia because this condition can have substantial clinical implications for both the mother and her offspring. Anemia has been linked with maternal mortality, increased risk of postpartum hemorrhage, sepsis, risk of intrauterine growth restriction, and preterm delivery . The first step to reducing these risks would be identification of anemia so that the necessary treatment and monitoring can be initiated.…”

Section: Discussionmentioning

confidence: 99%

“…Anemia is the most frequent indirect cause of adverse maternal outcomes and mortality, contributing to up to 50% of both . The risks of macerated late fetal death, fresh late fetal death, and early neonatal death are consistently increased among mothers with severe anemia .…”

Section: Introductionmentioning

confidence: 99%