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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 14113

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Dr. Betine Pinto Moehlecke Iser

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Graduate Program in Health Sciences, University of Southern Santa Catarina–UNISUL, Tubarão 88704-900, Santa Catarina, Brazil
Interests: epidemiological studies; chronic non-communicable diseases or conditions; aspects of pregnancy, delivery, and birth; maternal and child health

Special Issue Information

Dear Colleagues,

In view of the influence of the woman/mother's health on birth outcomes and child development until adulthood, the aim of this Special Issue is to focus our attention on diverse aspects of maternal, pregnancy, and child health, including the influence of the quality of care.

Maternal and neonatal/child health requires attention from all areas of social and scientific research in light of the United Nations’ Sustainable Development Goals to ensure healthy lives and promote well-being for all at all ages (SDG 3). Thus, this Special Issue welcomes research that aims to fill the main research gaps in order to achieve the following goals: eliminate avoidable maternal and perinatal mortality and morbidity, ensure universal access to sexual and reproductive healthcare, and promote a positive experience of pregnancy and childbirth.

We have a special interest in qualitative and epidemiological studies addressing women´s sexual and reproductive health, antenatal care, birth experiences, pregnancy diseases, gestational outcomes, and fetal and child development. We encourage the submission of original research, systematic reviews, meta-analyses, opinion pieces, or short communications.

We look forward to your contribution to this important theme of discussion.

Dr. Betine Pinto Moehlecke Iser
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

women health
maternal health
pregnancy
parturition
infant, newborn
postpartum period
epidemiology
quality of health care
perinatology
reproductive health services

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Published Papers (9 papers)

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Research

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18 pages, 910 KiB

Open AccessArticle

Prevalence of Maternal Anemia in Southern Jordan: Findings from a Cross-Sectional Study and 5-Year Review

by Ahlam M. Al-Kharabsheh, Israa F. Alahmad, Malak M. Al-Tamimi, Seham M. Abufraijeh and Nedal Alnawaiseh

Healthcare 2024, 12(24), 2495; https://doi.org/10.3390/healthcare12242495 - 10 Dec 2024

Viewed by 1030

Abstract

Background: The literature underrepresents maternal anemia in southern Jordan, and national studies often have small sample sizes. According to the 2019 Jordan National Micronutrient Survey, maternal anemia in Jordan accounted for 19.1% of cases, with the majority experiencing mild anemia (17.1%). Among the 29 pregnant women recruited from the southern region, 56.5% had anemia, of which 34.8% had mild and 21.7% had moderate anemia. The current study provides an update on the prevalence of anemia during pregnancy in southern Jordan. Methods: This cross-sectional study was conducted at a government referral hospital in southern Jordan. Pregnant women who visited outpatient clinics were included in the study. Data were collected through face-to-face interviews, and blood samples were collected to measure hemoglobin levels. Descriptive analyses of continuous and categorical variables were performed. Maternal anemia risk factors were assessed using the chi-square test, Fisher’s exact test, and multivariate logistic regression analysis. Statistical significance was defined at p < 0.05. Results: Of the 474 pregnant women who agreed to participate, 36.8% had anemia. Education, income, diet (number of meals and meat consumption), regularity of antenatal care, and supplement use were factors that significantly affected hemoglobin levels (p < 0.05). The adolescent pregnancy rate was 5.3%, and 48% had mild to moderate anemia. Conclusions: Maternal anemia rates in southern Jordan remained high, despite a slow decline. Reducing this burden requires improved access to healthcare and health education, particularly for rural residents who are at greater risk of disease. Full article

(This article belongs to the Special Issue Focus on Maternal, Pregnancy and Child Health)

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13 pages, 1564 KiB

Open AccessArticle

Fetal Growth Associated with Maternal Rheumatoid Arthritis and Juvenile Idiopathic Arthritis

by Eugenia Yupei Chock, Bente Glintborg, Zeyan Liew, Lars Henning Pedersen and Mette Østergaard Thunbo

Healthcare 2024, 12(23), 2390; https://doi.org/10.3390/healthcare12232390 - 28 Nov 2024

Viewed by 963

Abstract

Introduction: Patients with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) are at a twice-higher risk of developing adverse pregnancy outcomes, such as preterm births and infants with a low birth weight. We aimed to evaluate fetal growth among patients with and without rheumatoid arthritis and juvenile idiopathic arthritis (RA and JIA). Materials and Methods: We conducted a population-based cohort study in Denmark from 2008–2018, which included 503,491 singleton pregnancies. Among them, 2206 were pregnancies of patients with RA and JIA. We linked several nationwide databases and clinical registries in Denmark to achieve our aim. First, we used the International Classification of Diseases-10 codes to identify pregnant patients with RA and JIA from the National Patient Registry. Next, we obtained fetal biometric measurements gathered from second-trimester fetal ultrasound scans and birthweights through the Fetal Medicine Database. Finally, we computed a fetal growth gradient between the second trimester and birth, using the mean difference in the Z-score distances for each fetal growth indicator. We also calculated the risk of small for gestational age (SGA). All outcomes were compared between pregnant individuals with and without RA and JIA, adjusted for confounders. Results: Maternal RA and JIA were not associated with a reduction in the estimated fetal weight (EFW) at 18 to 22 weeks of gestational age [adjusted mean EFW Z-score difference of 0.05 (95% CI 0.01, 0.10)]. We observed reduced mean Z-score differences in the weight gradient from the second trimester to birth among offspring of patients with RA and JIA who used corticosteroids [−0.26 (95% CI −0.11, −0.41)] or sulfasalazine [−0.61 (95% CI −0.45, −0.77)] during pregnancy. Maternal RA and JIA were also associated with SGA [aOR of 1.47 (95% CI 1.16, 1.83)] and the risk estimates were higher among corticosteroid [aOR 3.44 (95% CI 2.14, 5.25)] or sulfasalazine [(aOR 2.28 (95% CI 1.22, 3.88)] users. Conclusions: Among pregnant patients with RA and JIA, fetal growth restriction seemed to occur after 18 to 22 weeks of gestational age. The second half of pregnancy may be a vulnerable period for optimal fetal growth in this population. Full article

(This article belongs to the Special Issue Focus on Maternal, Pregnancy and Child Health)

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9 pages, 242 KiB

Open AccessArticle

Gestational Outcomes Related to the Occurrence of Gestational Diabetes Mellitus: A Cohort Study

by Samara Souza Stork, Claudia Meurer Souza, Josiane Somariva Prophiro, Elizabeth Ann Brownell and Betine Pinto Moehlecke Iser

Healthcare 2024, 12(19), 1905; https://doi.org/10.3390/healthcare12191905 - 24 Sep 2024

Cited by 1 | Viewed by 1346

Abstract

Background: Gestational diabetes mellitus (GDM) is the main cause of hyperglycemia in pregnancy and is related to complications throughout the gestational and post-partum period. Objectives: To analyze the pregnancy outcomes related to the occurrence of GDM in women and their offspring. Methods: Third-trimester pregnant women were interviewed and monitored until childbirth. The diagnosis of GDM, blood glucose ≥ 92 mg/dL, was defined by the criteria of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG). Results: A total of 138 women participated, and there were 136 births (due to 2 fetal losses); 23 (16.7%) were diagnosed with GDM. The risk of complications during childbirth was higher among pregnant women with GDM (RR 3.40; 95%CI 1.65–7.00), as was the occurrence of cesarean birth (RR 1.9; 95%CI 1.46–2.59). The occurrence of preterm birth did not show a significant difference between GDM/non-GDM groups. There was a non-significant association in adjusted analyses of macrosomia (birth weight ≥ 4000 g) among newborns born to mothers with GDM (RR 1.27; 95%CI 0.67–2.38). For newborns born to pregnant women with GDM, there was a higher risk for the following outcomes: large for gestational age (LGA) (3.29 95%CI 1.62–6.64), low Apgar (4.98 95%CI 2.32–10.69), and birth asphyxia (9.51 95%CI 3.42–26.48). Conclusions: The findings reinforce that GDM is an important risk factor for adverse pregnancy outcomes for women and their offspring. Full article

(This article belongs to the Special Issue Focus on Maternal, Pregnancy and Child Health)

17 pages, 639 KiB

Open AccessArticle

Effect of Comprehensive Educational Program on Preeclamptic Women’s Risk Perception of Cardiovascular Disease, Self-Efficacy, and Adherence to Healthy Lifestyle Behaviors

by Nahed Ahmed Hussien, Hend Ali Mohamed Abd El-fatah, Zhenxiang Zhang, Hassanat Ramadan Abdel-Aziz, Ahmad Mahmoud Saleh, Kamala Dhakal, Yongxia Mei and Asmaa Morgan Farahat Khatap

Healthcare 2024, 12(18), 1810; https://doi.org/10.3390/healthcare12181810 - 10 Sep 2024

Viewed by 1026

Abstract

Purpose: To evaluate the effect of a comprehensive educational program on preeclamptic women’s knowledge, risk perception of cardiovascular disease, self-efficacy, and adherence to healthy lifestyle behaviors. Patients and methods: This study employed a pretest-posttest design. One hundred and two women who previously had preeclampsia were enrolled from July 2022 to December 2022 from outpatient obstetrics, gynecology, and family planning clinics. The primary and secondary outcomes were measured at baseline, after eight weeks, and after three months of the educational intervention. The data were analyzed using SPSS version 23, descriptive and inferential statistics, specifically the Chi-square test, independent t-tests, and repeated measures ANOVA. Results: A statistically significant difference was found between the two groups immediately post-intervention and the three-month follow-up, with a significant improvement among the intervention group than control group regarding cardiovascular disease knowledge (p < 0.001), risk perception (p < 0.001), self-efficacy (p < 0.001), and healthy lifestyle behaviors (p < 0.001). There was a statistically significant interaction between group and time regarding total cardiovascular disease risk perception (F = 203.67, p < 0.001, η2 = 0.673), self-efficacy (F = 70.06, p < 0.001, η2 = 0.405), and adherence to healthy lifestyle behaviors (F = 145.08, p < 0.001, η2 = 0.597). Conclusion: This study concluded that the comprehensive educational program had a positive effect on improving preeclamptic women’s knowledge and risk perception of CVD, self-efficacy, and adherence to healthy lifestyle behaviors following preeclampsia. Full article

(This article belongs to the Special Issue Focus on Maternal, Pregnancy and Child Health)

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12 pages, 745 KiB

Open AccessArticle

Family Planning and Preconception Care Service Management: The Key Role of Bulgarian GPs

by Eleonora Hristova-Atanasova, Georgi Iskrov and Rumen Stefanov

Healthcare 2024, 12(11), 1096; https://doi.org/10.3390/healthcare12111096 - 27 May 2024

Viewed by 1515

Abstract

Assisting women in attaining their reproductive goals is crucial for improving the well-being of families and children. As the first point of contact for healthcare, general practitioners (GPs) are ideal for family planning (FP) and preconception care (PCC). However, primary care interventions’ efficacy is unclear. The aim of this study was to examine GPs’ knowledge, attitudes, and perspectives on FP and PCC service management. Most GPs were aware of FP and PCC services and held a firm conviction that they should be primarily accountable together with obstetrician–gynaecologists. However, it is worth noting that less than 50% of respondents reported receiving thorough and comprehensive knowledge of their respective specialities. Those with general medicine qualifications demonstrated a high level of commitment to providing such services. The women’s GPs and those with training in general medicine prescribed birth control pills and emergency contraception three times more frequently than the other doctors who suggested condoms or traditional methods or referred patients to another specialist (p < 0.05). In conclusion, PCC is of the utmost importance, and its effective implementation demands the collaboration of policymakers, healthcare providers, and individuals. GPs are essential in managing FP and PCC. They must incorporate more in-depth PCC into their clinical practice. Full article

(This article belongs to the Special Issue Focus on Maternal, Pregnancy and Child Health)

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17 pages, 1496 KiB

Open AccessArticle

Identification of the Best Predictive Model for Mortality in Outborn Neonates—Retrospective Cohort Study

by Maria Livia Ognean, Bianca Coțovanu, Dumitru Alin Teacoe, Ioana Andrada Radu, Samuel Bogdan Todor, Cristian Ichim, Iris Codruța Mureșan, Adrian-Gheorghe Boicean, Radu Galiș and Manuela Cucerea

Healthcare 2023, 11(24), 3131; https://doi.org/10.3390/healthcare11243131 - 9 Dec 2023

Viewed by 1500

Abstract

Background: Transportation of sick newborns is a major predictor of outcome. Prompt identification of the sickest newborns allows adequate intervention and outcome optimization. An optimal scoring system has not yet been identified. Aim: To identify a rapid, accurate, and easy-to-perform score predictive for neonatal mortality in outborn neonates. Material and methods: All neonates admitted by transfer in a level III regional neonatal unit between 1 January 2015 and 31 December 2021 were included. Infants with congenital critical abnormalities were excluded (N = 15). Gestational age (GA), birth weight (BW), Apgar score, place of birth, time between delivery and admission (AT), early onset sepsis, and sick neonatal score (SNS) were collected from medical records and tested for their association with mortality, including in subgroups (preterm vs. term infants); GA, BW, and AT were used to develop MSNS-AT score, to improve mortality prediction. The main outcome was all-cause mortality prediction. Univariable and multivariable analysis, including Cox regression, were performed, and odds ratio and hazard ratios were calculated were appropriate. Results: 418 infants were included; 217/403 infants were born prematurely (53.8%), and 20 died (4.96%). Compared with the survivors, the non-survivors had lower GA, BW, and SNS scores (p < 0.05); only the SNS scores remained lower in the subgroup analysis. Time to admission was associated with an increased mortality rate in the whole group and preterm infants (p < 0.05). In multiple Cox regression models, a cut-off value of MSNS-AT score ≤ 10 was more precise in predicting mortality as compared with SNS (AUC 0.735 vs. 0.775) in the entire group and in the preterm infants group (AUC 0.885 vs. 0.810). Conclusions: The new MSNS-AT score significantly improved mortality prediction at admission in the whole study group and in preterm infants as compared with the SNS score, suggesting that, besides GA and BW, AT may be decisive for the outcome of outborn preterm infants. Full article

(This article belongs to the Special Issue Focus on Maternal, Pregnancy and Child Health)

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14 pages, 892 KiB

Open AccessArticle

Physical Activity Participation of Black and White Women during the First Year Postpartum: Results and Study Recruitment Strategies

by Erin E. Kishman, Lauren A. Castleberry and Xuewen Wang

Healthcare 2023, 11(19), 2625; https://doi.org/10.3390/healthcare11192625 - 26 Sep 2023

Cited by 1 | Viewed by 1345

Abstract

Background: Little is known about how physical activity participation changes throughout the first year postpartum. This may be due to the difficulty in recruiting this population. The aims of this study were first to describe the recruitment methods and second to examine physical activity in the first year postpartum. Methods: Black and White women who gave birth to a singleton infant at ≥37 weeks gestation were recruited by a variety of strategies. At 6–8 weeks (baseline) and 4, 6, 9, and 12 months postpartum, women were instructed to wear an accelerometer for 7 days. Results: Active recruitment with interactions between staff and potential participants was more successful than non-active strategies for enrolling women. Throughout the first year postpartum, physical activity counts and light and moderate-to-vigorous physical activity increased from baseline (165.2 and 21.5 min, respectively) to 12 months (185.0 and 27.6 min, respectively). Sedentary time decreased from 775.3 min at baseline to 749.4 min per day at 12 months. In this sample, Black participants had lower physical activity (counts per minute per day) and greater sedentary time than White participants. Conclusions: Active strategies were more successful in recruiting women into the study. Of those who enrolled, physical activity levels increased over time. Identifying barriers to physical activity that may change over the postpartum period will help develop more targeted interventions to increase physical activity. Full article

(This article belongs to the Special Issue Focus on Maternal, Pregnancy and Child Health)

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12 pages, 267 KiB

Open AccessArticle

Perceived Cardiovascular Disease Risk Following Preeclampsia: A Cross-Sectional Study

by Nahed Ahmed Hussien, Nazia Shuaib, Zeinab Ali Baraia, Adel Omar Laradhi, Wenna Wang and Zhenxiang Zhang

Healthcare 2023, 11(16), 2356; https://doi.org/10.3390/healthcare11162356 - 21 Aug 2023

Cited by 5 | Viewed by 1630

Abstract

Preeclampsia has been linked to an increased risk of cardiovascular disease (CVD), and the preeclamptic women were unaware of this link. Therefore, this study aims to assess women’s knowledge and perception of future CVD after preeclampsia. This study used a cross-sectional descriptive design. Two hundred and forty-six women with a preeclampsia history were recruited from the Al Salam MCH Center and Suez Canal University Hospital. Data were collected during March 2022 using a socio-demographic questionnaire, an Adapted Coronary Heart disease knowledge tool for preeclamptic women, and The Perception of Risk of Heart Disease Scale (PRHDS). Most women (96%) were unaware of the relationship between CVD and preeclampsia. The women had a low CVD knowledge level (10.26 ± 6.08) as well as a low perception of cardiovascular disease risk (37.15 ± 7.22). There was a significant positive correlation between CVD knowledge and CVD risk perception (r = 0.434, p = 0.000). This study found that preeclampsia survivors underestimated their CVD risk. Based on these findings, preeclamptic women should receive health education sessions on CVD risk and prevention from their nurses and obstetricians. The hospital pre-discharge plan must contain these sessions in written and electronic formats to help women remember and follow CVD risk reduction measures. Full article

(This article belongs to the Special Issue Focus on Maternal, Pregnancy and Child Health)

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27 pages, 1049 KiB

Open AccessReview

Evidence-Based Lessons from Policy Implementation Research in Two Countries Achieving Progress on Global Breastfeeding Targets: Recommendations from the Philippines and Viet Nam

by Catherine Pereira-Kotze, Paul Zambrano, Tuan T. Nguyen, Janice Datu-Sanguyo, Duong Vu, Constance Ching, Jennifer Cashin and Roger Mathisen

Healthcare 2025, 13(5), 544; https://doi.org/10.3390/healthcare13050544 - 3 Mar 2025

Viewed by 2066

Abstract

Background/Objectives: There is extensive evidence that breastfeeding saves lives, improves health, and provides value to the economy and societies worldwide. The Philippines and Viet Nam have progressive policies to enable breastfeeding, and breastfeeding rates in these countries have substantively improved. In the Philippines, exclusive breastfeeding under six months (EBF) increased from 35.9% (2008) to 60.1% (2021) and, in Viet Nam, in just over a decade, EBF has more than doubled, from 17.0% (2010) to 45.4% (2021). We aimed to use an evidence synthesis to consolidate learnings from policy support to enable breastfeeding in the Philippines and Viet Nam, to identify insights to improve future programming to improve breastfeeding practices in these two countries, and glean learnings that can potentially be adapted for similar contexts. Methods: This manuscript presents a qualitative evidence synthesis of seven purposively selected research articles from the Philippines and Viet Nam. Results: Since the 1960s, the Philippines and Viet Nam have notably improved policies protecting breastfeeding. Both countries have implemented legislation that is substantially aligned with the International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly resolutions. Both countries have improved paid maternity leave provisions, with Viet Nam providing 6 months of paid leave, yet insufficient coverage to informal workers, and the Philippines providing 3.5 months of paid maternity leave while expanding maternity protection coverage to informal workers. From 2006–2021, breastfeeding rates increased in both countries alongside policy improvements yet barriers to implementation remain. Conclusions: Implementation research has documented policy progress and improved breastfeeding rates in the Philippines and Viet Nam. Our analysis offers valuable lessons potentially applicable beyond these contexts, emphasizing the need for addressing policy gaps and targeted cross-sectoral policy actions to enhance breastfeeding practices. Learnings from implementing national marketing restrictions of commercial milk formula and associated products and maternity protection policies in these countries could inform the implementation of newly developed regional standards together with supportive policies, facilitating the harmonization of regional regulatory environments. Full article

(This article belongs to the Special Issue Focus on Maternal, Pregnancy and Child Health)

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