Prenatal Health

by

M. Anne George, Mary H. George

• LAST REVIEWED: 02 February 2016
• LAST MODIFIED: 26 May 2016
• DOI: 10.1093/obo/9780199756797-0096

Introduction

Maternal and fetal health covers a spectrum of topics, including maternal and fetal mortality and morbidity and their causes such as adequate health care, risks associated with environmental and lifestyle exposures, maternal stress, maternal diseases, and many other health issues. Both maternal and fetal deaths are an enormous burden. In many developing countries, a strong emphasis is placed on policy and practice initiatives to reduce maternal, fetal, and newborn mortality because complications of pregnancy and childbirth remain a leading cause of death. The World Health Organization (WHO) estimates that 1,500 women die daily due to complications in pregnancy or childbirth and that 10,000 babies are born stillborn or die in the first month of life. In these countries, malnutrition is a major contributor to women’s preventable morbidity and mortality and has considerable adverse outcomes for the developing fetus. Elsewhere in the world where maternal and fetal mortality rates are lower, long-term consequences of maternal and fetal stressors, poor nutrition, environmental or behavioral teratogens, and maternal disease are the major concern. This has led to considerable research, and development of best practice guidelines, that focus on maternal behaviors and diseases, prenatal environmental exposures, including prenatal alcohol and tobacco exposure, and treatment of preexisting conditions such as depression. Some issues, such as HIV/AIDS and nutrition, affect maternal and prenatal health throughout the world but to differing degrees.

General Overviews

Maternal health has been defined by the WHO across three periods: “Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While motherhood is often a positive and fulfilling experience, for too many women it is associated with suffering, ill-health and even death. The major direct causes of maternal morbidity and mortality include haemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labour” (WHO, Maternal Health). There are a limited number of general introductory works on the topics of maternal health and fetal development and the risks to fetal health. Sigelman and Rider 2010 describes health and risks across the life span, including fetal development and risks from maternal behaviors and environmental exposures. Gilbert and Epel 2009 similarly describes the human in relation to its environment, with fetal development being a more predominant topic than maternal health.

• Gilbert, S. F., and D. Epel. 2009. Ecological developmental biology: Integrating epigenics, medicine and evolution. Sunderland, MA: Sinauer.

  Ecological development biology is the study of the interaction of the organism and its environment and includes the impact on the organism of pathological environments, including nutrition and teratogens. This book has chapters relevant to fetal health on teratogenic agents, endocrine disruptors, and fetal development of adult diseases.

• Sigelman, C. K., and E. A. Rider. 2010. Life-span human development. 7th ed. Belmont, CA: Wadsworth.

  Taking a life-span approach to health, this book explores development theories and has a well-documented section on prenatal development and birth. It includes summaries on human development theories, stages of fetal development, known teratogens, and perinatal environments.