Maternal and Newborn Health Research Roundup – August 2025

1.

Individual and community level determinants of unmet pregnancy complication education among pregnant ANC visitor women in Sub-Saharan Africa: a multilevel analysis of the recent demographic and health survey

This study examines the prevalence and determinants of unmet pregnancy complication education (UPCE) among antenatal care visitors in Ethiopia, Gabon, and Senegal. Using data from over 20,000 women, researchers found that two out of five pregnant women lacked adequate education on pregnancy complications. Key individual-level factors included low education, poverty, limited ANC visits, and distance from health facilities, while community-level ANC utilization and country-specific disparities also played significant roles. The study highlights systemic barriers such as overburdened healthcare providers and lack of structured educational programs. Addressing these gaps through targeted interventions and improved provider training is essential to reduce maternal mortality and improve pregnancy outcomes. (July 2025)

2.

Hypertensive disorders of pregnancy and perinatal outcomes: two prospective cohort studies of nulliparous women in India and Tanzania

Two large cohort studies in India and Tanzania investigated the impact of hypertensive disorders of pregnancy (HDP) on perinatal outcomes among nulliparous women. The research found that all forms of HDP, especially pre-eclampsia with severe features, significantly increased the risk of perinatal death, preterm birth, and low birth weight. Early-onset HDP (<34 weeks) posed the highest risk, with perinatal death rates reaching 25.6% in India and 36.9% in Tanzania. These findings emphasize the urgent need for early detection and intervention strategies in resource-limited settings, where the burden of adverse outcomes is disproportionately high. (July 2025)

3.

Flooding and elevated prenatal depression in rural Bangladesh: A mixed methods study

This mixed methods study investigates the relationship between flooding and prenatal depression among 881 pregnant women in rural Bangladesh. Quantitative analysis revealed that flooding of residential compounds was significantly associated with elevated depression (aPR = 2.08) and thoughts of self-harm (aPR = 8.40). Latrine flooding further increased depression risk (aPR = 3.58), and proximity to surface water correlated with higher depression scores. Qualitative findings from focus groups highlighted domestic violence, poor sanitation, and food insecurity as key contributors to mental distress. The study underscores the urgent need for climate-resilient infrastructure and mental health support in flood-prone regions to mitigate the psychological impact on pregnant women. (21 July 2025)

4.

Risk factors associated with progression from pre‐eclampsia to eclampsia: A prospective cohort study and population‐wide data analysis

This study identifies key risk factors for the progression from pre-eclampsia to eclampsia in low- and middle-income settings, using data from Uganda and Ecuador. In Uganda, progression was significantly associated with nulliparity (OR 2.4), Baganda ethnicity (OR 1.9), and paternal unemployment (OR 2.8), while younger maternal age showed a borderline association. In Ecuador, younger age and public healthcare use were linked to higher progression risk. Notably, severity of pre-eclampsia and number of antenatal visits were not predictive. These findings suggest that social and demographic factors may be more critical than clinical indicators in identifying women at highest risk, emphasizing the need for tailored monitoring strategies in resource-limited environments. (14 May 2025)

5.

A Novel Approach to Assessing the Potential of Electronic Decision Support Systems to Improve the Quality of Antenatal Care in Nepal

his mixed-methods study evaluated the implementation of two electronic decision support systems (EDSSs)—a WHO digital ANC module and a locally integrated mHealth model—in 19 primary-level health facilities in Nepal. Despite their potential to enhance adherence to antenatal care (ANC) guidelines and improve detection of high-risk pregnancies, the EDSSs did not consistently improve care quality. Key barriers included limited staff training, poor integration with existing workflows, and inflexible system design that failed to align with real-world clinical decision-making. Facility readiness and provider confidence varied, and many ANC components were either omitted or delivered at inappropriate times. The study highlights that digital tools alone are insufficient to transform care without supportive infrastructure, user-centered design, and health system integration. These findings offer critical insights for policymakers and implementers aiming to scale EDSSs in low-resource settings. (August 2025)

6.

Antenatal Corticosteroids and Child Neurodevelopment

This systematic review of the evidence aimed to determine the effect of antenatal corticosteroid administration on childhood neurodevelopmental outcomes from studies that have a design that minimized the risk of confounding. The authors evaluated the certainty of evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). A total of 14 studies (eight randomized controlled trial follow-up studies [n=2,233] and six quasi-experimental studies [n=277,679]) were included. Most neurodevelopmental outcomes examined (19/23) showed no association with antenatal corticosteroid administration. Among studies with low or moderate risk of bias, the authors found no association between antenatal corticosteroid administration and adverse child neurodevelopment. (September 2025)