High-Risk Pregnancy Management: From Prenatal Care to Postpartum Outcomes

A special issue of Epidemiologia (ISSN 2673-3986).

Deadline for manuscript submissions: 25 July 2026 | Viewed by 1376

Editor


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Guest Editor
Department of Obstetrics & Gynecology, University of Alberta, Edmonton, AB, Canada
Interests: maternal medicine; nutrition in pregnancy; preeclampsia; preterm birth; perinatal mental health; perinatal health of disadvantaged populations; maternal and child health epidemiology; developmental physiology
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Special Issue Information

Dear Colleagues,

High-Risk Pregnancy Management: From Prenatal Care to Postpartum Outcomes is a novel supplement that unites clinical science, implementation pragmatics, equity, and postpartum mental health (including depression, anxiety, PTSD, and birth trauma) across the full perinatal continuum, while addressing the continuous changes in AI use, implementation, and liability in obstetrical practice.

Despite abundant evidence on hypertensive disorders, cardiometabolic disease, preterm birth, hemorrhage, infection, autoimmune/hematologic conditions, and perinatal mental health and substance use, translation into consistent practice remains fragmented—particularly in Indigenous, rural/remote, and resource-constrained contexts. The supplement’s objectives are to (1) consolidate practice-changing evidence on major high-risk conditions and comorbidities; (2) convert evidence into standardized pathways, algorithms, and care bundles that are feasible across levels of care; (3) apply an equity lens that directly informs clinical decisions and outcomes—providing culturally safe communication scripts, trauma- and violence-informed assessments, and shared decision aids that reduce missed diagnoses, shorten time-to-treatment, and improve continuity for Indigenous and rural/remote patients; and (4) present EMR-enabled, point-of-care decision supports and pragmatic QI methods—early-warning thresholds, order sets, and unit-level feedback—that measurably improve bedside processes (e.g., time to antihypertensive, hemorrhage escalation, steroid/magnesium administration) and reduce complications.

In parallel, the supplement will provide guidance for navigating rapid shifts in AI-enabled tools—clarifying how evolving capabilities, implementation models, and medico-legal responsibilities affect clinicians and patients, and how shared decision-making and transparent consent can balance expectations with risk.

Topic coverage spans hypertensive disorders, cardio-obstetrics, diabetes/obesity, preterm birth and perinatal inflammation, hemorrhage readiness, infectious risks, and autoimmune/hematologic management; populations and settings (adolescents, advanced maternal age, multiples, and culturally grounded Indigenous and rural/remote care including transport and virtual care); and systems building through EMR order sets, alerts, dashboards, audit and feedback, quality trend monitoring, data governance, and patient-partnered ethics—aiming to measurably improve outcomes from antenatal triage through postpartum transitions.

Submission types welcomed: Article and Review.

You may choose our Joint Special Issue in JCM.

Dr. Angela Vinturache
Guest Editor

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Keywords

  • high-risk pregnancy
  • prenatal care
  • postpartum outcomes
  • postpartum mental health
  • birth trauma
  • AI in obstetrics
  • medico-legal liability
  • equity and culturally safe care
  • indigenous and rural/remote care
  • EMR-enabled decision support
  • quality trend monitoring
  • maternal morbidity and mortality
  • perinatal morbidity
  • standardized care bundles and pathways
  • maternal mortality and near-miss
  • perinatal mortality and morbidity
  • risk prediction
  • pharmacoepidemiology (pregnancy exposures)

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Published Papers (1 paper)

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Research

20 pages, 736 KB  
Article
Individual- and Community-Level Predictors of Birth Preparedness and Complication Readiness: Multilevel Evidence from Southern Ethiopia
by Amanuel Yoseph, Lakew Mussie, Mehretu Belayineh, Francisco Guillen-Grima and Ines Aguinaga-Ontoso
Epidemiologia 2026, 7(1), 13; https://doi.org/10.3390/epidemiologia7010013 - 14 Jan 2026
Viewed by 872
Abstract
Background/Objectives: Birth preparedness and complication readiness (BPCR) is a cornerstone of maternal health strategies designed to minimize the “three delays” in seeking, reaching, and receiving skilled care. In Ethiopia, uptake of BPCR remains insufficient, and little evidence exists on how individual- and [...] Read more.
Background/Objectives: Birth preparedness and complication readiness (BPCR) is a cornerstone of maternal health strategies designed to minimize the “three delays” in seeking, reaching, and receiving skilled care. In Ethiopia, uptake of BPCR remains insufficient, and little evidence exists on how individual- and community-level factors interact to shape preparedness. This study assessed the determinants of BPCR among women of reproductive age in Hawela Lida district, Sidama Region. Methods: A community-based cross-sectional study was conducted among 3540 women using a multistage sampling technique. Data were analyzed with multilevel mixed-effect negative binomial regression to account for clustering at the community level. Adjusted prevalence ratios (APRs) with 95% confidence intervals (CIs) were reported to identify determinants of BPCR. Model fitness was assessed using Akaike’s Information Criterion (AIC), the Bayesian Information Criterion (BIC), and log-likelihood statistics. Results: At the individual level, women employed in government positions had over three times higher expected BPCR scores compared with farmers (AIRR = 3.11; 95% CI: 1.89–5.77). Women with planned pregnancies demonstrated higher BPCR preparedness (AIRR = 1.66; 95% CI: 1.15–3.22), as did those who participated in model family training (AIRR = 2.53; 95% CI: 1.76–4.99) and women exercising decision-making autonomy (AIRR = 2.34; 95% CI: 1.97–5.93). At the community level, residing in urban areas (AIRR = 2.78; 95% CI: 1.81–4.77) and in communities with higher women’s literacy (AIRR = 4.92; 95% CI: 2.32–8.48) was associated with higher expected BPCR scores. These findings indicate that both personal empowerment and supportive community contexts play pivotal roles in enhancing maternal birth preparedness and readiness for potential complications. Random-effects analysis showed that 19.4% of the variance in BPCR was attributable to kebele-level clustering (ICC = 0.194). The final multilevel model demonstrated superior fit (AIC = 2915.15, BIC = 3003.33, log-likelihood = −1402.44). Conclusions: Both individual- and community-level factors strongly influence BPCR practice in southern Ethiopia. Interventions should prioritize women’s empowerment and pregnancy planning, scale-up of model family training, and address structural barriers such as rural access and community literacy gaps. Targeted, multilevel strategies are essential to accelerate progress toward improving maternal preparedness and reducing maternal morbidity and mortality. Full article
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