Antenatal care strategies to improve perinatal and newborn outcomes.

Abstract

Background: Antenatal care strategies (ANC) play a pivotal role in ensuring a healthy gestational period for expectant mothers and promote optimal outcomes for their babies. Implementing these interventions can contribute to a supportive environment for pregnant women, resulting in positive perinatal and neonatal outcomes.

Summary: We summarize evidence for a total of twenty-seven interventions pertaining to ANC from Every Newborn Series published in The Lancet 2014 by identifying the most recent systematic reviews, extracting data from each review, and conducting a sub group analysis for low-income and lower-middle-income countries (LICs/LMICs) for outcomes relevant to maternal and neonatal health. Findings from our paper suggest a paucity in evidence from LMICs, and consolidated efforts are required to narrow this gap to build on more inclusive evidence on antenatal care strategies. .

Key messages: Evidence from LMICs suggests that antenatal multiple micronutrient supplementation when compared to iron and folic acid, had a significant effect on stillbirth, small-for-gestational-age (SGA) and low birthweight (LBW). Vitamin D supplementation reduced the risks of preterm birth and LBW. High-dose calcium supplementation, when compared to placebo in pregnancy, lowered the likelihood of developing high blood pressure, pre-eclampsia and preterm birth. Antihypertensives significantly reduced the probability of developing severe hypertension, proteinuria/pre-eclampsia and severe pre-eclampsia. Metformin for GDM reduced the risk of neonatal death or serious morbidity composite. Cervical cerclage had no effect on stillbirth, preterm birth, or perinatal and neonatal mortality. Data for anti-D administration for rhesus alloimmunization was limited to HICs.