Index
A
Abortion
costs related to, 51
data on, 187
female feticide, 145, 253, 328
legalization, 75, 171, 322-323
maternal mortality, 28, 44, 47, 49-51, 75, 191
misoprostol-induced, 244
unsafe, 7, 24, 28, 44, 47, 49-51, 75, 333
Access to care
antenatal, 278
and birth outcomes, 29-30
childbirth complications and, 29-30, 47, 58
communication barriers, 170
cultural barriers, 7, 26, 57, 96
economic barriers, 6, 10, 66, 176, 192
family planning services, 6-7, 23
geographic barriers, 10, 58, 73, 170, 176
HIV testing and treatment, 278-279
referral care for labor and delivery, 10, 42, 176-178, 191-192, 277, 295-296
Acute respiratory infections, 32, 92, 93, 95, 278.
See also Pneumonia
Adolescent pregnancy
contraceptive availability and, 24
domestic violence and, 26
fetal and neonatal mortality, 24, 25, 144
and IUGR, 208
maternal risks, 7
Adverse birth outcomes.
See also Fetal mortality;
Maternal morbidity and mortality;
Neonatal morbidity and mortality;
other specific outcomes
access to care and, 29-30
linking mother, fetus, and neonate in, 29
vital registration coverage, 8, 27-28, 192, 333
Africa.
See also individual countries
birth rate, 23
childbirth management practices, 76
low birth weight, 206
maternal deaths and causes, 3, 43, 44, 45, 49, 50, 51
smoking prevalence, 211
STD prevalence, 143
viral hepatitis, 49
AIDS. See HIV/AIDS;
Prevention of perinatal HIV transmission
AIDS Clinical Trials Group, 268, 270-271, 279
Alcohol-related neurodevelopmental disorder, 245
Alcohol use during pregnancy, 52, 103, 145-146, 211, 239, 244-245, 246, 249, 254
American College of Nurse Midwives, 181
Ampicillin, 220-221
Anemia
causes and sequelae, 47, 48, 49, 55, 98, 147, 151, 211, 222, 241, 242
prevalence, 56
prevention and treatment, 55, 56, 106, 151, 222
Antenatal care
anemia prevention, 56, 151-152
in community facilities, 167
cost-effectiveness, 280-281, 282
diabetes management, 152
education of women on, 151, 174, 176, 218
essential, 107, 119, 294, 295-296
and fetal mortality, 151-152
HIV/AIDS prevention and control, 31, 107, 262, 266, 279-284, 285
hypertensive disease management, 54-55, 78, 107, 151
infection detection and treatment, 55, 96, 103-105, 151, 152
international initiatives, 33
and IUGR and preterm birth, 222
and maternal mortality, 54-58, 60
maternal nutrition, 57, 147, 152, 217-219, 254
neonatal benefits of, 54, 90, 102-107
recommendations, 78, 80, 117, 167, 254, 285
screening for defects and disorders, 21, 31, 33, 54, 104, 107, 248, 253, 262, 266, 279-284
sickle cell disease management, 151-152
skilled birth attendant’s competencies, 312
Antepartum fetal mortality, 9, 28-29, 134, 141-148, 153-154, 324
Antibiotics, 55, 60, 71, 75, 79, 94, 98-99, 103-104, 108, 113, 143, 150, 172, 204, 220-221
Anticoagulant drugs, 224, 239, 244, 250
Anticonvulsant drugs, 71, 73-75, 172, 239, 244, 250
Antihypertensive drugs, 54-55, 73-74, 223
Antimalarial drugs, 55, 79, 147-148, 221
Antiretroviral drugs
administration costs, 277
and breastfeeding, 278
combination therapy, 267-268, 269, 274-275, 276
costs of drugs, 268, 276-277, 278, 280-281
nevirapine, 268, 269, 274-275, 276, 279, 280-281, 284
resistance to, 276
toxicity and risks, 274-276
zidovudine, 267, 268-275, 279, 280-281, 284
Apgar scores, 99
Apnea, 99
Argentina, 107, 186, 207, 209, 216, 222
Armenia, 62-63
Asia.
See also individual countries
abortion, 50
birth rate, 23
cesarean sections, 76
low birth weight, 206
maternal deaths and causes, 45, 50, 51
neonatal mortality, 64
smoking prevalence, 211
TB cases, 95
viral hepatitis, 49
Asphyxia, 28, 29, 92, 99-100, 109-110, 118-119, 139, 140, 150, 153, 188, 191, 325
Aspirin, 223
Autopsies and death audits, 135, 152, 175, 188
Azerbaijan, 62-63
Azithromycin, 221
B
Bacillus Calmette-Guérin (BCG) vaccine, 113-114
Bacteriuria, asymptomatic, 54, 55, 98-99, 104, 107, 117, 204, 220, 223
Bangladesh, 62-63, 97, 105, 106, 136, 213, 219
Bednets, insecticide-impregnated, 55
Behavioral change
defined, 325
education interventions for, 52-53, 79, 102-103
Bilirubin encephalopathy, 101, 102
Bill and Melinda Gates Foundation, 34, 182
Birth defects.
See also Complex birth defects;
Environmental birth defects;
Genetic birth defects;
individual disorders
causes and risk factors, 11, 31, 236, 238-247
early diagnosis and treatment, 248, 250-251, 253
impact reduction strategy, 236, 248-254
IUGR and, 212
prevalence, 11, 30-31, 236, 237, 238, 241, 246
prevention, 248-250
recommendations, 254
registries, 238
research needs, 254-255
Birth injury, 92, 100, 139, 140-141, 150
Birth intervals, 6, 7, 23, 24, 25-26, 47, 212.
See also Parity
Birth order, 247
Birth outcomes. See Adverse birth outcomes;
specific outcomes
Birth rates, 23
Blood safety, 151
Blood transfusions, 47-48, 60, 70, 73, 110, 149, 151, 172, 241
Bolivia, 51, 62-63, 105, 180, 182
Bosnia and Herzegovina, 27
Brazil, 62-63, 101, 136, 140, 141, 144, 169, 215, 216, 321, 322
Breastfeeding, 93, 95, 96, 101, 105, 110, 111-112, 113, 116, 204, 212, 223, 267, 268, 269, 270-271, 274-275, 277-278, 282-283, 284-285
Breech/transverse presentation, 51, 54, 100, 106, 107, 140, 150, 180, 188
Bronchopulmonary dysplasia, 216
Burkina Faso, 62-63, 179, 268, 270-271
C
Cambodia, 62-63
Cameroon, 62-63
Cannabis, 147
Carbamazepine, 244
CARE, 182
Caribbean
HIV/AIDS, 264
maternal deaths and causes, 45, 51
neonatal mortality, 64
smoking prevalence, 211
STD prevalence, 143
Cefixime, 221
Centers for Disease Control and Prevention, 3-4, 18, 276
Central America, viral hepatitis, 49.
See also individual countries
Cephalopelvic disproportion, 140
Cephalosporin, 220
Cervical incompetence, 222, 224
Cesarean section, 48, 60, 66, 69, 72, 75, 76, 109, 149, 150, 152, 174, 179, 191, 213, 214, 268, 277, 326
Chad, 62-63
Chancroid, 109
Child mortality and morbidity, 23, 25, 29, 31, 33, 57, 264, 266, 267
Child Survival Initiative, 31-32, 34, 52
Childbirth.
See also Skilled birth attendants
access to care, 29-30, 42, 47, 58, 176-178
cesarean section, 48, 60, 66, 69, 72, 75, 76, 109, 149, 150, 152, 174, 179, 191, 213, 214, 268, 277, 326
clean delivery, 65, 97, 107-108, 109, 119, 180, 326
complications, 29-30, 47, 48, 51-52, 57, 58, 61, 69-70, 71-74, 90, 106, 107, 139-140, 143-144, 150, 312
cord complications, 94, 100, 140, 143
educational interventions, 174, 188
essential obstetric care, 11-12, 47, 71-74, 77-78, 80, 118, 149, 172, 173, 192, 223-224, 254, 294, 295-297, 324-325
essential package of interventions, 71
external cephalic version, 54, 106, 150
fetal monitoring, 76, 149, 153
and fetal mortality, 8, 28, 29, 51, 66, 138-139, 149-150, 153
first stage of labor, 65-69
forceps extraction, 66, 71, 75, 76
home delivery, 48, 58-59, 61, 94, 96, 97, 100, 101, 108, 110, 168, 170-172, 173
hospital/clinic delivery, 58, 60, 66-67, 72, 172-174
infections, 66, 71, 73, 75, 76, 108-109, 150, 178
malpresentation, 51, 54, 100, 106, 107, 140, 150, 180, 188
management, 29, 32, 42, 65-75, 76, 107-112, 138-139, 149-150, 153, 191, 193, 311, 312
neonatal care during, 90, 107-112
obstructed labor, 24, 28, 29, 44, 47, 51-52, 54, 72, 75, 106, 139-140, 150, 178, 191, 311, 330
oxytocin drug augmentation, 66, 69, 70-71, 76, 108, 149, 172
partograph monitoring, 65-69, 150, 180, 330
prolonged labor, 29, 51, 57, 66, 75, 100, 139-140, 150, 178, 311, 331
referral care for complications, 42, 149, 176-178, 191-192, 295-296
research needs, 174-175
second stage of labor, 69
social consequences of problems, 51-52
third stage of labor, 69-71
traditional beliefs and practices, 7, 26, 57, 96
trauma to neonate, 92, 100, 139, 140-141, 150
vaginal examinations, 76, 108, 149, 150
China, 46, 97, 136, 139, 169, 170, 171, 172, 188, 207, 209, 321, 322
Chinese Birth Defects Monitoring Program (CBDMP), 238
Chlamydia, 97, 98, 104, 204, 220
Chloriquine, 221
Chorioamnionitis, 108, 143, 148, 150
Chronic diseases, fetal origins of, 215-216, 224
Cleft lip and/or cleft palate, 239, 244, 245, 247, 251, 255
Clindamycin, 220
Clinical trials
antiretroviral drugs, 268, 270-275
community health services, 166
nutrient supplementation, 218, 219
Clubfoot. See Talipes
Cocaine, 147
Cochran Database of Systematic Reviews, 69, 76, 151, 217, 218, 219, 268-269, 274
Collaborative Study of Maternal Anthropometry and Pregnancy Outcomes, 206, 207, 208, 209
Communication capacity for referrals, 170, 177
Community health programs.
See also Primary health care
birthing homes/centers, 172, 178
capacity building, 167, 172, 298, 325
communication services, 170, 177
home care for neonates and sick children, 32, 113, 114
maternity waiting homes, 172, 178, 210
randomized controlled trials, 166
recommendations, 192
support for referral services, 170, 177, 183
village health workers, 113, 114-115, 116, 167, 168, 171, 172, 175
Complex birth defects, 238, 239, 246-247.
See also specific disorders
Congenital heart disease, 239, 240, 244, 245, 246-247, 251
Congenital infections, 96, 97, 98, 105, 239, 242, 246, 249-250, 255
Congenital malformations, 92, 97, 100, 142, 144, 152, 212, 238, 239, 240, 246-247
Consanguineous unions, 241, 242
Contraceptive prevalence, 23, 24
Coronary heart disease, 215, 216
Corticosteroids, 110-111
Cost-effectiveness of interventions
antenatal screening programs, 251, 280-281, 282
defined, 326
HIV/AIDS interventions, 278, 279, 280-281
immunization programs, 105
of maternal interventions, 52
nutrition-related programs, 57, 79
referral support, 177
reproductive health care, 190-191
STD diagnosis and treatment, 103, 151
Costs
of abortion complications, 51
antiretroviral drugs, 268, 276-277, 280-281
instruments for estimating, 189, 190
of reproductive health services, 189-190
Coumarin, 244
Counseling
of breastfeeding mothers, 111
on genetic risks, 152, 250, 253-254
for maternal behavioral change, 53, 90, 204, 224, 254
peer, 111
preconceptional, 250
to recognize childbirth complications, 57
smoking cessation, 224
to use skilled birth attendant, 52, 57-58, 90
Cuba, 21, 107, 207, 209, 222, 253
Cultural barriers
to obstetric and neonatal care, 7, 26, 27, 57, 96, 180, 247
traditional beliefs and birthing practices, 7, 26, 57, 96
Curaçao, 136
Cyprus, 252-253
Cytomegalovirus, 48, 118, 142-143
D
Data on birth outcomes.
See also Surveillance
collection and analysis, 15, 16, 184, 187-188, 192-193, 298
cultural barriers to collection, 7, 8, 27
fetal deaths, 135, 138, 152, 153, 175, 188
inadequacy of, 8, 27-28, 212, 237, 238
and intervention development, 188
recommendations, 15, 16, 192-193, 298
vital registration coverage, 8, 27-28, 185-186, 187, 192, 333
Denmark, 146-147
Developed countries
abortion, 50
LBW, 30
maternal mortality, 17, 43, 50, 60, 64
neonatal mortality, 64
pediatric HIV/AIDS, 31
Developing countries.
See also individual countries
characteristics shared by, 305-306
classification by per capita income, 307-309
defined, 46
expenditures for health care, 10, 178-179, 182, 282
fertility rates, 25
fetal deaths, 3, 17, 134, 135-137
health personnel shortages in, 9-10, 178
health reforms, 183-184
infectious disease burden, 21-22, 92
LBW, 30
maternal deaths, 3, 17, 42, 44, 50, 59
neonatal deaths, 3, 17, 64, 90, 91, 92
Developmental dysplasia of the hip, 239, 245, 247, 251, 255
Diabetes mellitus, 48, 139, 142, 149, 152, 215, 216, 239, 243
See also Screening for diseases and disorders
Diarrheal disease, 32, 92, 93, 96, 111, 115, 278
Diazempam, 74
Dinoprostone, 73
DITRAME ANRS trial, 270-271
Dominican Republic, 62-63
Down syndrome, 24, 150, 239, 240, 246, 249, 253, 254, 255
Dystocia, 140
E
Echocardiography, 247
Eclampsia, 26, 28, 44, 47, 51, 73-75, 191, 326-327.
See also Hypertensive disorders of pregnancy
Economic factors.
See also Cost-effectiveness of interventions;
Costs;
Poverty
in access to care, 66, 176, 192
and fetal mortality, 141
in HIV/AIDS epidemic, 264, 283
in IUGR, 214
Ecuador, 186
Education of women. See Health education
Educational status of women, 6, 22-23, 146
El Salvador, 62-63
Energy/protein requirements, 148, 209-210, 217-218, 224
Environmental birth defects.
See also Complex birth defects;
Teratogens
alcohol consumption and, 239, 244-245, 249
and IUGR, 212
maternal illness and, 31, 96, 98, 238, 239, 242-243, 249-250
maternal nutrition and, 238, 239, 243-244
medications and, 238, 244, 250
Environmental pollutants, 245
Epilepsy, 244
Ergometrine, 70-71
Erythromycin, 220
Escherichia coli, 94
Ethical considerations, 59, 282, 283, 284
Europe.
See also individual countries
maternal mortality, 44, 45, 57
smoking prevalence, 211
European Collaborative Study, 266
European Register of Congenital Abnormalities and Twins (EUROCAT), 238
External cephalic version, 54, 106, 150
F
Family planning services, 6-7, 23, 24, 33, 75, 78, 80, 150-151, 167, 171, 181, 248, 249
See also Parity
Female infanticide, 145
Female literacy, 23
Fertility rates, 25
Fetal alcohol syndrome, 145, 146, 211, 239, 245, 255
Fetal interventions
antenatal care, 151-152
childbirth management, 138-139, 150
detection and management of distress, 76, 149, 153
family planning, 150-151
infection management, 150
intrapartum care, 149-150, 153
recommendations, 153
research needs, 153
Fetal monitoring, 76, 149, 153
Fetal mortality, 9
antepartum, 9, 28-29, 134, 141-148, 153-154, 324
autopsy and fetal death audit, 135, 152, 175, 188
birth interval and, 25
causes of death, 188
childbirth complications and, 28, 29, 51, 66, 138-139, 149-150, 153
classification systems, 153
domestic violence and, 26
female feticide, 145
geographic distribution, 3, 17, 21, 134, 135-137, 139, 142
hypertensive disease of pregnancy and, 29, 100, 139, 141, 142, 143, 148, 151, 188
intrapartum, 8, 9, 28-29, 66, 134, 138-141, 148-149, 153, 328
maternal age and, 24, 25, 29, 144, 146
maternal infections and, 49, 96, 97, 139, 142-143, 147-148, 150, 204, 211, 221, 225
poverty and, 145
rates, 3, 17, 21, 134, 135-137
recognition/record of deaths, 135, 138, 152, 153, 175, 188
risk factors, 9, 21, 22, 25, 134, 138-148
surveillance and analysis, 134, 152, 154, 187
Fiji, 136
Folate/folic acid, 47, 56, 107, 147, 152, 188, 219, 239, 243, 246, 248-249, 254
Forceps extraction, 66, 71, 75, 76
G
Gambia, 54, 55, 73, 93-94, 137, 148, 180, 207, 209, 210, 218
See also Women’s status
Genetic birth defects.
See also Complex birth defects;
individual disorders
chromosomal disorders, 7, 24, 150, 238, 239, 240
counseling about risk, 152, 249, 250, 253-254, 255
detection, 253
examples of, 240-242
maternal age and, 7, 24, 150, 249
risk factors and sequelae, 56
screening for, 21, 252-254, 255
single-gene disorders, 238, 239, 240-242, 253
Ghana, 62-63, 76, 139, 140, 141, 142
Glucose-6-phosphate dehydrogenase (G6PD) deficiency, 239, 242, 252, 253
Goiter, 243
Greece, 252
Group B streptococcus, 94, 106, 108, 118
Guatemala, 178, 180, 207, 209, 210, 214, 217
Guinea, 62-63
H
Haemophilus influenzae type B (HiB), 106, 118
Health care systems, 9-11.
See also Primary health care;
Reproductive health care
capacity building, 9-10, 16, 30, 164, 165, 167, 172, 178-184, 284, 298, 325
essential elements, 9-10, 14-15, 164, 165, 184, 294, 295-296
evaluation of models of care, 164, 166, 168, 184-185, 193
expenditures in developing countries, 10, 178-179, 182
managing, 184-191
recommendations, 15-16, 191-193, 298
surveillance of pregnancy and birth outcomes, 15, 16, 152-153, 164, 181, 187-189, 192-193
Health education
on antenatal services, 151, 174, 176
for behavioral change, 52-53, 79, 90, 102-103
breastfeeding promotion, 111-112
on childbirth safety concerns, 174, 188
on HIV/AIDS, 278
and LBW, 222
mass media approaches, 218
nutrition, 52, 111, 152, 218-219
research needs, 79
Health personnel, 23.
See also Skilled birth attendants
female literacy and, 6
professional development and training, 170, 171, 179, 181, 184, 188
shortages in developing countries, 9-10, 178
village health workers, 113, 114-115, 116, 167, 168, 171, 172, 175
Health services.
See also Primary health care;
Reproductive health care
decision-making process, 184-185
donor contributions, 52, 182, 183-184
evaluation of, 184-185
evidence-based care, 185, 327-328
maternal, 52;
see also Antenatal care;
Postpartum care;
Preconceptional care
monitoring health care delivery and outcomes, 194
national policy and leadership, 192
neonatal care, 167-168
priority setting, 192, 293-294
public-private collaborations, 106, 178, 180-182
quality of care, 141, 168, 174, 194
Hemorrhage.
See also Postpartum hemorrhage
and anemia, 56
intrapartum, 139, 141, 143, 147, 151
maternal mortality, 28, 44, 47, 51, 191
skilled attendant’s management competency, 310
Hepatitis. See Viral hepatitis
Herpes simplex virus, 98
HIV/AIDS.
See also Prevention of perinatal HIV transmission
blood transfusions and, 47-48
burden globally, 21, 93, 262, 265
child mortality, 262, 264, 266, 267
and fetal mortality, 143
maternal mortality, 28
nutritional interventions, 220, 267
opportunistic infections, 95, 96
orphans, 283
perinatal transmission, 11, 31, 96, 103, 266-267
prevalence in women of childbearing age, 11, 28, 264-266, 280-281
risk factors and sequelae, 6, 49, 56, 95, 103, 105, 267, 282-283
and stigma and discrimination, 262, 282, 284, 285
testing and counseling, 104, 278, 280-281
HIVNET, 274-275
Home-based care
childbirth, 48, 58-59, 61, 94, 96, 97, 100, 101, 108, 110, 168, 169, 170-172, 173
neonatal, 32, 113, 114, 116, 119, 120, 213-214, 295, 321-322
transition to facility-based care, 172-174
Hookworm infections, 47, 56, 106, 107
Hospitals
childbirth management in, 58, 60, 66-67, 72, 169, 172-174
nosocomial infections, 96, 118
public vs. private, 21, 141, 183
Hyperbilirubinemia, 101-102, 110, 328
Hypertension, 215
Hypertensive disorders of pregnancy
defined, 328
and fetal mortality, 29, 100, 139, 141, 142, 143, 148, 151, 188
management of, 54-55, 70-71, 73-75, 78, 107, 149, 151, 222-223, 311
maternal mortality, 51
and IUGR and preterm birth, 222-223, 225
and PPH, 70-71
referral services, 178
Hypocalcemia, 214
Hypothermia, 100-101, 110, 111, 116
Hypoxia, 214
Hysterectomy, 72
I
Immunization.
See also Vaccines;
individual diseases
cost-effectiveness, 105
maternal, 90, 96, 97, 105-106, 108-109, 117, 118, 249-250, 254
research needs, 118
India, 21, 22, 56, 58, 91, 97, 101, 113, 114-115, 116, 141, 144, 188, 206, 207, 209, 210, 213-214, 215-216, 241, 283, 295, 321, 322
Indonesia, 46, 62-63, 97, 101, 181, 207, 209, 218
Industrialized countries.
See also Developed countries
defined, 46
Infant mortality.
See also Neonatal morbidity and mortality
defined, 328
female literacy and, 23
poverty and, 21
skilled birth attendant and, 61, 63, 64
Infections and infectious diseases.
See also HIV/AIDS;
Malaria;
other specific diseases
antenatal detection and treatment, 55, 96, 103-105
antibiotic-resistant pathogens, 79, 94-95, 109
and birth defects, 31, 96, 98, 238, 239
congenital, 96, 97, 98, 105, 239
control package, 118
cultural practices and, 96
and fetal mortality, 49, 96, 97, 139, 142-143, 148, 150
intrapartum, 150
management in childbirth, 66, 71, 73, 75, 76, 108-109, 150
maternal, 29, 31, 48-52, 79, 90, 93, 96, 97, 98-99, 103, 139, 148, 191, 266-267
mother-to-child transmission, 31, 96, 97, 98, 103, 118, 266-267
neonatal, 28, 32, 79, 90, 92-99, 108-109, 112-113, 118, 191
and preterm birth, 55, 204, 208, 211-212, 220-221
recognition and treatment in neonates, 112-113
risk factors, 21-22
Initiative for Maternal Mortality Programme Assessment, 59
Institute of Medicine, 283
Integrated Management of Childhood Illness, 32, 112-113
International Classifications of Diseases (ICD), 10, 43-44
International Clearinghouse for Birth Defects Monitoring System (ICBDMS), 238
International Clinical Epidemiology Network (INCLEN), 181
International Conference on Primary Health Care, 166-167
International Nutritional Anemia Consultative Group, 56
International Planned Parenthood Federation, 32
Interventions. See Fetal interventions;
Maternal interventions;
Neonatal care
Intrapartum
fetal mortality, 8, 9, 28-29, 66, 134, 138-141, 148-149, 153, 328
hemorrhage, 139, 141, 143, 147, 151
HIV/AIDS therapy, 269, 274, 279, 284
infections, 150
Intrauterine growth restriction (IUGR)
alcohol consumption and, 211
and birth defects, 212
birth interval and, 212
causes, risk factors, and sequelae, 6, 22, 28, 29, 30, 98, 99, 100, 140, 144, 204, 207-214, 222-223, 224
defined, 328
family size/parity and, 210
genetic associations, 212, 214, 218
geographic distribution, 206, 207, 213
and infant mortality, 28, 30, 191, 212-213
interventions to prevent, 204, 217-223
maternal infections and, 211, 220-221
maternal nutrition and, 22, 29, 204, 208-211, 217-220, 224-225
and morbidity, growth, and development, 28, 191, 214-216
physical activity and, 210-211
proportionality indices, 214-215
relative risk, 212-213
research needs, 224
smoking and, 146, 204, 211, 223
ultrasound measurement, 215
Iodine
deficiency disorders, 219, 239, 243-244, 255
fortification of foods, 249, 254
Iraq, 210
Iron
deficiency, 47, 56, 106, 147, 152, 219
overload, 241
J
Jamaica, 62-63, 136, 139, 140, 141, 142, 144, 152, 153, 175
Jamaican Perinatal Mortality Survey, 140
Japan, 245
Jaundice, neonatal, 98, 101-102, 110, 253
Joint United Nations Programme on HIV/AIDS, 264
Jordan, 62-63
K
Kangaroo care, 110, 116, 119, 204, 223, 328-329
Karyotyping, 253
Kenya, 55, 56, 62-63, 177, 220, 267
Kernicterus, 101, 102, 253, 329
Kick charts, 149
Klebsiella infections, 94
Kuwait, 62-63
Kyrqyz Republic, 62-63
L
Labor and delivery. See Childbirth
Large for gestational age infants, 152
Latin America.
See also individual countries
abortion, 50
birth rate, 23
cesarean sections, 76
fetal mortality and risk factors, 21, 139, 142
low birth weight, 206
maternal deaths and causes, 45, 50, 51
smoking prevalence, 211
Latin American Center for Perinatalogy and Human Development, 25-26
Latin American Collaborative Study of Congenital Malformations (ECLAMC), 238
Least developed countries
defined, 46
fertility rates, 25
tetanus, 97
Lebanon, 62-63
Leprosy, 244
Low birth weight.
See also Intrauterine growth restriction;
Preterm birth
anthropometric measurement, 206-207
antibiotic treatment and, 220-221
causes and sequelae, 6, 7, 11, 30, 55, 74, 95, 96, 97, 99, 100, 103, 104, 188, 204, 205
defined, 329
neonatal care, 110, 116, 188, 204, 223
patterns of occurrence, 11, 30, 204, 205-207, 213
psychosocial support and, 222
recommendations, 223-224
and reporting of births and deaths, 187
research needs, 224
and thermal control, 110
M
Madagascar, 62-63
Magnesium, 219
Magnesium sulfate, 73, 75, 100
Magpie Trial, 75
Making Pregnancy Safer Initiative, 33
Malaria
fetal effects, 147-148, 204, 211, 221, 225
and maternal mortality, 44, 47
neonatal effects, 29, 48, 99-100, 204, 221
prevention and treatment, 32, 52, 55, 56, 78, 79, 105, 107, 152, 204, 221, 224
research needs, 79
risk factors and sequelae, 6, 48-49, 56, 106
sickle cell disease and, 242
Malawi, 56, 143, 148, 179, 207, 209, 267
See also Maternal nutrition
Maternal age
and birth defects, 7, 24, 150, 238, 240, 249, 255
and chronic medical disorders, 150-151
and fetal mortality, 24, 25, 29, 144, 146
and IUGR, 208
and neonatal morbidity and mortality, 24, 25, 144
and preterm birth, 213
and smoking, 146
Maternal and child health, 32.
See also Child Survival Initiative;
Safe Motherhood Initiative
Maternal-Fetal Medicine Network, 220
Maternal interventions.
See also Maternal nutrition
antenatal care, 54-58, 60, 223
behavioral change, 52-53, 79, 90, 102-103
childbirth management, 29, 32, 42, 65-75, 76, 107-112, 138-139, 149-150, 153, 191, 193
deaths averted by, 43
education, see Health education
effectiveness of, 52
essential package of, 71, 294, 295-296
evidence base on, 217
immunization, 90, 96, 97, 105-106, 108-109, 117, 118, 249-250
overused or inappropriate, 48, 76
recommendations, 77-78, 118, 223-224, 254
research needs, 52-53, 56, 78-79, 224
Maternal morbidity and mortality
abortion and, 28, 44, 47, 49-51, 75, 191
and birth defects, 238, 242-243, 249-250
birth intervals and, 25-26
causes of death, 8, 28, 42, 43, 44-52, 75, 77, 191
and child survival probability, 29
deaths annually, 45
epidemiological trends, 61
epilepsy, 244
geographic distribution of, 3, 17, 42, 43, 44, 45, 49, 50, 51, 59, 60, 64
historical trends, 59-60
infections, 29, 31, 44, 47, 48-52, 79, 90, 93, 96, 97, 98-99, 103, 139, 148, 191, 211, 220-221, 223-224, 238, 266-267
interventions. See Maternal interventions
lifetime risk of dying, 3, 17, 42, 44, 45
and neonatal health, 29, 48, 90, 99-100, 204, 221
nutrition and, 43, 47, 48, 51, 56
ratios, 44, 45, 52, 62, 321, 329
research needs, 78-79
skilled birth attendants, 42, 58-65, 173
women’s status and, 6, 22-23, 77, 80, 102-103
Maternal nutrition
antenatal care, 57, 147, 152, 217-219
and birth defects, 31, 238, 239, 243-244, 248-249
causes of deficiencies, 56, 209
cost-effectiveness of interventions, 57, 79
“eating down,” 209
educational campaigns, 52, 111, 152, 218-219
energy/protein, 148, 209-210, 217-218, 224
folate, 47, 56, 107, 147, 152, 188, 219, 239, 243, 246, 248-249, 254
fortification of foods, 248-249
guidelines for pregnant women, 56
interventions, 57, 79, 217-220, 224
iodine, 219, 239, 243-244, 249, 254, 255
iron, 47, 56, 106, 147, 152, 219
and IUGR, 22, 29, 204, 208-211, 217-220, 224-225
magnesium, 219
and maternal morbidity and mortality, 43, 47, 48, 51, 56
micronutrients, 56, 106, 148, 218-219
n-3 polyunsaturated fatty acids, 219
preconceptional, 217-218, 248-249
and preterm birth, 217-220
research needs, 56, 79, 148, 219, 224
supplements, 57, 147, 152, 188, 217-219, 224, 243, 249
vitamin B12, 56
Maternity waiting homes, 172, 178, 210
Mauritania, 62-63
Measles, 32
Mebendazole, 222
Medications.
See also Antiretroviral drugs
abortifacients, 49
antibiotics, 55, 60, 71, 75, 79, 94, 98-99, 103-104, 108, 113, 143, 150, 172, 204, 220-221
anticoagulant drugs, 224, 239, 244
anticonvulsant drugs, 71, 73-75, 172, 239, 244
antihypertensive drugs, 54-55, 73-74
antimalarial drugs, 55, 79, 147-148
oxytocic drugs, 66, 69, 70-71, 76, 108, 149
postpartum hemorrhage control, 73
MEDLINE, 217
Mental retardation, 74, 98, 216, 240, 243, 245
15-Methyl PGF, 73
Methylergonovine, 73
Metronidazol, 220-221
Micronutrients, 56, 106, 148, 218-219
Middle East.
See also individual countries
birth defects, 241
consanguineous marriages, 241
smoking prevalence, 211
viral hepatitis, 49
Midwives and midwifery, 9, 60, 61, 65, 167, 168, 170, 171, 173, 175, 178, 180, 181, 184, 329-330.
See also Health personnel;
Skilled birth attendants
Misoprostol (RU-486), 71, 73, 149, 239, 244, 250
Mortality. See Fetal morbidity and mortality;
Maternal morbidity and mortality;
Neonatal morbidity and mortality
Mother-Baby Package, 33, 189, 191
Mozambique, 62-63, 75, 101, 137, 139, 179, 186
Mycobacterium bovis, 113
N
National Institute for Child Health and Human Development, 4, 18
National Institutes of Health, 4, 18, 220
Natural disasters, 26-27
Necrotizing fascitis, 94
Neonatal care.
See also Breastfeeding
birth defects, 248, 250-251, 253
during childbirth, 90, 107-112
cord care practices, 108-109, 119
corticosteroids, 110-111
disease recognition and treatment, 112-113
essential, 117, 172, 192, 294, 295-296, 327
home-based, 32, 113, 114, 116, 119, 120, 213-214, 295, 321-322
infection control package, 118
integrated approach to, 112-113
Kangaroo care, 110, 116, 119, 204, 223, 328-329
for low-birth-weight infants, 110, 116, 188, 204, 223
preterm birth and, 213-214
recommendations, 90, 116-117, 321
research needs, 117-119
resuscitation, 99, 109-110, 116, 118-119, 153, 172, 180
skilled birth attendant’s competencies, 311-312, 321
thermal control, 101, 110, 116, 172
traditional practices, 247
Neonatal interventions. See Neonatal care
Neonatal morbidity and mortality
antenatal care and, 54, 90, 102-107
birth defects, 28, 92, 238-240
birth injury, 100
birth interval and, 25
breastfeeding and, 111-112
burden of mortality, 91
causes of death, 9, 28, 51, 64, 76, 90, 91-102, 188, 191
challenges to health, see Birth defects;
Low birth weight
childbirth management and, 100, 107-112
cultural context, 27
definitional issues, 27, 187, 330
geographic distribution, 3, 17, 64, 90, 91, 92
hypothermia, 100-101, 110, 111, 116
infectious diseases, 28, 32, 79, 90, 92-99, 108-109, 112-113, 118, 191
interventions, 9, 90, 102-116, 253;
See also Neonatal care
jaundice/hyperbilirubinemia, 98, 101-102, 110
maternal health and nutrition and, 29, 48, 90, 99-100, 204, 221
noninfectious conditions, 99-102
perinatal asphyxia, 28, 29, 92, 99-100, 109-110, 118-119, 139, 140, 150, 153, 188, 191
preterm delivery and, 28, 92, 191, 216
rates, 3, 17, 18, 33, 61, 90, 321-322, 330
vital registration coverage, 8, 27, 187, 333
Nepal, 57, 62-63, 76, 101, 136, 141, 207, 209
Neural tube defects, 188, 239, 243, 244, 245, 246, 248, 253, 255
Neurodevelopmental disability, 100
Nevirapine, 268, 269, 274, 276, 279, 280-281, 284
Nicaragua, 62-63
Niger, 62-63
Nigeria, 56, 69, 137, 177, 242
Night blindness, 57
Nongovernmental organizations, 178, 181
North America
maternal deaths, 45
neonatal mortality, 91
Norway, 60
Nurses, 9, 10, 167, 168, 171, 178.
See also Health personnel;
Skilled birth attendants
Nutrition.
See also Breastfeeding;
Maternal nutrition
O
Obesity, maternal, 145, 152, 216
Obstructed labor, 24, 28, 29, 44, 47, 51-52, 54, 72, 75, 106, 139-140, 150, 178, 330
Oceania, maternal deaths, 45
Oligohydramnios, 143
Omphalitis, 94
Operation Smile, 251
Oxytocin, 66, 69, 70-71, 73, 76, 149, 172
P
Papua New Guinea, 62-63, 93-94, 98, 106, 108, 141, 143, 210, 241
Paraguay, 62-63
Parasites and parasitic infections, 47, 56, 106, 107, 147
Parity, 7, 23, 24-26, 144-145, 330
Partograph monitoring, 65-69, 150, 180, 330
Perinatal HIV Prevention trial, 268, 270-271
Perinatal mortality rates, 21, 330-331
Phenobarbital, 244
Phenylketonuria, 253
Philippines, 62-63, 93-94, 136, 214
Phototherapy, 110
Physicians, 9, 175, 178, 179, 181.
See also Health personnel;
Skilled birth attendants
Placental abruption, 139, 141, 143, 147, 151, 324
Placental infarction, 141
Plasmodium falciparum, 55, 152
Plasmodium vivax, 55
Pneumonia, 92, 95, 98, 104, 106, 108, 113, 242
Political conflicts, 26-27
n-3 Polyunsaturated fatty acids, 219
Population Council, 32
Portugal, 62-63
Postpartum hemorrhage
hypertensive disease of pregnancy and, 70-71
management of, 47-48, 69-70, 71, 72, 73, 180
and maternal mortality, 46-48
Poverty
and access to health services, 6, 10, 66, 176, 192
and fetal mortality, 145
and infant mortality, 21
and infectious disease, 6, 21-22
Preconceptional care
counseling, 250
genetic screening, 248, 252-253
neonatal benefits of, 90
recommendations, 13-14, 78, 117, 167, 223, 254, 285, 297
rubella testing, 250
Pregnancy.
See also Adolescent pregnancy;
Childbirth;
Hypertensive disorders of pregnancy;
Maternal age;
Unintended pregnancy
alcohol use during, 52, 103, 145-146, 244-245, 249
ectopic, 187
integrated management of childbirth and, 32
multiple gestation, 100, 140, 144, 213
Premature rupture of membranes, 48, 75, 108, 143, 211-212, 220, 331
Prenatal care. See Antenatal care
Preterm birth
antibiotic treatment and, 220-221
causes and risk factors, 96, 97, 99, 204, 207-208, 211-212, 213, 222-223
cervical incompetence, 222, 224, 326
consequences, 95, 101, 102, 140, 212-217
defined, 331
domestic violence and, 26
genetic associations, 212
and infant/neonatal mortality, 28, 30, 92, 191, 213-214
interventions, 55, 110, 204, 216, 217-223
maternal infections and, 55, 204, 208, 211-212, 220-221
maternal nutrition and, 217-220
and morbidity, growth, and development, 28, 92, 216
and neonatal care, 213-214
relative risk, 212-213
research needs, 224
Prevention of perinatal HIV transmission
antenatal screening, 31, 107, 262, 266, 279-284
antiretroviral strategies, 11, 31, 244, 262, 263, 266, 267-277, 279, 284
breast milk substitutes, 111, 277-278, 279, 284-285
comparison of interventions, 278-279
minimum standard of care, 268
recommendations, 284-285
vaginal lavage, 277
vitamin A therapy, 277
Primary health care.
See also Reproductive health care;
Skilled birth attendants
Alma-Ata Declaration, 166-167
childbirth models of care, 10, 168-175, 322
“close-to-client” model, 167, 168
defined, 167
home birth models, 170-172
hospital/clinic birth models, 172-174
referral care for labor and delivery, 10, 33, 42, 52, 58, 65, 149, 164, 167, 171, 175, 176-178, 295-296, 321
Primidone, 244
Private sector, reproductive health care role, 180-182
Private voluntary organizations, 182
Products of conception, retention, 48, 71, 140
Professional organizations, 178
Prolonged labor, 29, 51, 57, 66, 75, 100, 139-140, 150, 178, 331
Psychosocial support for mothers, 222
R
Radiation. See Ionizing radiation
Radiography, diagnostic, 105, 245
Recommendations
antenatal care, 13-14, 78, 80, 117, 223, 254, 284-285, 297-298
birth defect reduction, 254
concerns about implementation, 320-323
data collection, 15, 16, 192-193, 298
essential obstetric care, 11-12, 77-78, 118, 223-224, 254, 296-297, 324-325
fetal interventions, 153
health care systems, 15, 191-193, 298
HIV/AIDS prevention and control, 284-285
immediate priorities, 11-14, 296-298
LBW prevention, 223-224
neonatal interventions, 90, 116-117
preconceptional care, 13-14, 78, 117, 167, 223, 254, 285, 297
skilled birth attendants, 12, 64-65, 77, 80, 107-108, 116-117, 168, 191-192, 296-297
Recreational drug use, 143, 147, 239
Recto-vaginal fistulae, 51
Refugees, 26-27
Reproductive health, defined, 20
Reproductive health care.
See also Antenatal care;
Postpartum care
barriers to, 6-7, 24, 26, 29-30, 72-73, 75
basic, 248
cost-effectiveness, 190-191
donor contributions, 182, 183-184
essential obstetric care, 10, 47, 71-74, 77, 80, 149, 294, 295-296, 324-325
evaluation of interventions, 164, 189-191, 193
expenditures, 182
family planning services, 6-7, 23, 24, 33, 75, 78, 80, 167, 171, 181, 248, 249
financing, 179, 182-183, 193, 321
health care reforms, 183-184
priorities, 293-294
private-sector role, 180-182
referral care for obstetric complications, 10, 33, 42, 52, 58, 65, 149, 164, 175, 176-178, 295-296, 321
rural sources of, 114
staff development and training, 179-180
Research needs
autopsy studies, 153
behavioral change strategies, 52-53
birth defects, 254-255
educational strategies, 79
emphasis of recommendations, 20
ethical issues, 59
evaluation of interventions, 59, 78, 79, 119, 164, 168, 193, 254
fetal monitoring, 153
health care systems, 193
HIV/AIDS prevention and control, 277, 285-286
infectious disease control, 79, 118, 224, 277
IUGR, 224
low birth weight, 224
maternal interventions, 52-53, 56, 78-79, 224
nutrition interventions, 56, 79, 148, 219, 224
preterm birth, 224
priority setting, 78
surveillance, 254
Respiratory distress syndrome, 95, 110-111, 216
Resuscitation, 99, 109-110, 116, 118-119, 153, 172, 180
Retinopathy of prematurity, 216
RETROCI trial, 270-273
Rh hemolytic disease, 101-102
Rohrer’s ponderal index, 214-215
Rubella, 6, 105, 142, 239, 242-243, 246, 249, 250, 255
Russian Federation, 62-63
S
Safe Motherhood Initiative, 17, 32-33, 34, 52
Sardinia, 252
Saudi Arabia, 62-63, 107, 222, 241
Save the Children, 182
Saving Newborn Lives Initiative, 34
Scotland, 25
Screening for diseases and disorders
antenatal, 33, 54, 104, 253, 279-284
barriers to, 279-283
for birth defects, 236, 248, 251-253
cost-effectiveness, 280-281, 282
counseling on risks, 253-254
guidelines, 283-284
for HIV/AIDS, 279-284
for hypertensive disease of pregnancy, 54, 78, 151
neonatal, 253
research needs, 79
social, cultural, and ethical concerns, 282-283
for STDs, 104
for TB, 104-105
WHO guidelines, 283-284
Sepsis
causes, risk factors, and sequelae, 6, 48, 49, 51, 93-94
defined, 332
fatality rate, 93
maternal, 28, 44, 47, 48, 49, 51, 66, 332
neonatal, 92, 93-95, 108, 111, 114, 115, 178, 278
Sexual differentiation disorders, 240
Sexually transmitted diseases, 109.
See also individual diseases
adverse pregnancy outcomes, 97-98, 142
and childbirth complications, 48
cost-effectiveness of interventions, 103, 151
diagnosis and treatment, 103-104, 107, 109, 117, 118
domestic violence and, 26
intrapartum interventions, 109
mother-to-child transmission, 93, 97-98, 109, 118, 143
poverty and, 21-22
prevalence, 143
research needs, 118
women’s status and, 266
Sickle cell disease, 56, 142, 149, 151-152, 239, 241-242, 252, 332
Skilled birth attendants
attitudinal and cognitive skills, 312-313
clinical strategies during childbirth, 61-65, 72, 149, 312
competencies, 109-110, 119-120, 149, 167, 180, 310-313
counseling women to use, 52, 54, 57-58, 90
epidemiological trends, 61
evidence of effectiveness of, 42, 59, 61, 320, 321
historical trends, 59-60
and infant mortality, 61, 63, 64
and maternal mortality, 42, 58-65, 173
monitoring performance of, 180
and neonatal mortality, 90, 170
recommendations, 12, 64-65, 77, 80, 107-108, 116-117, 168, 191-192, 296-297
research needs, 59
transportation needs, 177
Small for gestational age, 206, 333.
See also Intrauterine growth restriction
Smoking, 52, 103, 139, 143, 146-147, 204, 211, 221, 223, 224, 225
Socioeconomic status of women, 6, 22-23
South Africa, 62-63, 97, 115, 170, 216, 220-221, 269, 272-273, 281
South Asia, neonatal morbidity and mortality, 91
Southeast Asia
HIV/AIDS, 264
partograph monitoring trial, 66
Spina bifida, 243, 246, 247, 333
Sri Lanka, 21, 62-63, 136, 141, 169, 170, 172, 175, 182, 207, 209, 222, 321
Staphylococcus aureus, 94
Stillbirths, 21, 25, 138, 333.
See also Fetal mortality
Sub-Saharan Africa
expenditures for health care, 282
genetic birth defects, 241, 242
HIV/AIDS in, 31, 263-264, 280-281
malaria, 48
smoking prevalence, 211
Sulfadoxine-pyrimethamine, 55, 221
Surveillance
of antibiotic use and antibiotic-resistant microorganisms, 94-95, 119
defined, 333
of fetal deaths, 134, 152, 154, 187
of nosocomial infections, 118
of pregnancy and birth outcomes, 44, 152-153, 164, 181, 187-189, 192-193
prospective system, 188-189, 193
public-private partnerships, 181
registration of births and deaths, 44, 185-187
research needs, 255
Swedish International Development Authority, 182
Syndromic treatment, 103
Syntometrine, 70-71
Syphilis, 48, 93, 97-98, 103, 104, 107, 109, 117, 142-143, 148, 151
T
Talipes or clubfoot, 239, 245, 247, 250-251, 255
Tanzania, 27, 62-63, 103, 137, 179, 210, 220, 269, 272-273
Teratogens.
See also Environmental birth defects
pathogens, 96, 97, 98, 105, 239, 242-243
Tetanus, 34, 49, 90, 92, 93, 94, 96-97, 105-106, 107, 108-109
Thailand, 107, 152, 186, 207, 209, 210, 222, 268, 270-271
Thalassemias, 56, 239, 241, 252-253
Thalidomide embryopathy, 244
Thermal control, 101, 110, 116, 172
Thrombocytopenia, 98
Toxoplasma, 142-143
Traditional birth attendants, 7, 26, 33, 65, 105, 113, 115, 170-171, 172, 173, 175, 180, 188, 294-295, 321, 322, 333
Transplacental congenital infections, 96
Transportation to referral facilities, 10, 58, 73, 170, 176, 177, 183
Trinidad and Tobago, 62-63
Tuberculosis, 95-96, 104-105, 107, 113-114, 117
Tunisia, 62-63
Turkey, 62-63
U
Uganda, 103, 221, 269, 272-275
Umbilical cord
complications, 94, 100, 140, 143
infections, 108
UNAIDS, 278
Unintended pregnancy, 6-7, 23-24, 33
United Kingdom, 10, 60, 70, 74-75, 169, 207, 209, 215
United Nations Children’s Fund (UNICEF), 30, 32, 34, 56, 58, 182, 187, 278
United Nations Convention on the Rights of the Child, 186
United Nations Development Program (UNDP), 32, 182
United Nations Fund for Population Activities, 32, 58, 182, 187
United States, 10, 60, 62-63, 146, 169, 186, 207, 209, 213, 263, 267, 268, 283, 322
Urinary tract infections, maternal, 54, 55, 98-99, 104, 107, 117, 142, 208, 220-221
U.S. Agency for International Development, 4, 18, 32, 182
Uterine dysfunction, 24
Uterine perforation, 49
Uterotonic drugs, 70
Uzbekistan, 62-63
V
See also Immunization
Vaginal examinations, 76, 108, 149, 150
Vaginal infections, 21-22
Vaginal lavage, 277
Valproate, 244
Vesico-vaginal fistulae, 51
Village health workers, 113, 114-115, 116, 167, 168, 171, 172, 175, 295
Violence. See Domestic violence;
Political conflicts
Viral hepatitis, 28, 44, 48, 49, 107, 114, 143
Vitamin B12, 56
W
Wales, 147
War. See Political conflicts
Women’s status, 145
childbirth complications and, 51-52
and HIV transmission, 266
and maternal and neonatal health, 6, 22-23, 77, 80, 102-103
World Bank, 32, 58, 182, 191, 283, 322
World Health Organization, 30, 32, 33, 56, 58, 93-94, 103, 111, 114, 182, 187, 206, 278, 283-284
Y
Yemen, 62-63
Young Infants Study, 93-94
Yugoslavia, 62-63
Z
Zidovudine, 267, 268-275, 279, 280-281, 284
Zimbabwe, 62-63, 69-70, 101, 137, 140, 144, 148, 153, 178, 186
