Near-term and Intrapartum Care of Mothers for Perinatal and Newborn Outcomes.

Abstract

Introduction: Near-term and intrapartum care play pivotal roles in ensuring a safe childbirth experience and are essential components of a comprehensive approach to maternal and neonatal health.

Methods: The following interventions were identified: antibiotics for preterm premature rupture of membrane, antenatal corticosteroids for fetal lung maturation, partograph use during labor and delivery, induction of labor at or post term, skilled birth care and safe childbirth checklist during labor and delivery. A scoping exercise was conducted to ascertain the most up-to-date evidence, and reviews of topics of interest were updated in case the evidence was not recent, with a focus on low- and middle- income countries (LMICs).

Results: Antibiotics reduced the overall risk of neonatal infection including pneumonia [RR 0.67 (0.52 to 0.85)]. LMIC evidence showed a significant effect of antenatal steroids on the risk of neonatal mortality [RR 0.64 (0.43 to 0.97)] and respiratory distress syndrome [RR 0.65 (0.44 to 0.96)]. Induction of labor practices at term or post-term reduced the risk of meconium aspiration syndrome [RR 0.51 (0.34 to 0.76)]. The use of the WHO childbirth checklist significantly raised the standard of pre-eclampsia care [OR 8.09 (2.55 to 25.63)] as well as of maternal infection management [OR 25.44 (4.09 to 158.08)]. LMIC-specific evidence also demonstrated a significant reduction in the risk of stillbirth [OR 0.92 (0.87 to 0.96)].

Conclusion: Further research initiatives pertaining to health interventions delivered to expectant mothers near term or during the intrapartum period can contribute to a more inclusive understanding of health challenges in LMICs.