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      Interactions between the Physical and Social Environments with Adverse Pregnancy Events Related to Placental Disorders—A Scoping Review

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          Abstract

          Background: Due to different social and physical environments across Africa, understanding how these environments differ in interacting with placental disorders will play an important role in developing effective interventions. Methods: A scoping review was conducted, to identify current knowledge on interactions between the physical and social environment and the incidence of placental disease in Africa. Results: Heavy metals were said to be harmful when environmental concentrations are beyond critical limits. Education level, maternal age, attendance of antenatal care and parity were the most investigated social determinants. Conclusions: More evidence is needed to determine the relationships between the environment and placental function in Africa. The results show that understanding the nature of the relationship between social determinants of health (SDH) and placental health outcomes plays a pivotal role in understanding the risk in the heterogenous communities in Africa.

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          Global action on the social determinants of health

          Angela Donkin, Peter Goldblatt, Jessica Allen … (2017)
          Action on the social determinants of health (SDH) is required to reduce inequities in health. This article summarises global progress, largely in terms of commitments and strategies. It is clear that there is widespread support for a SDH approach across the world, from global political commitment to within country action. Inequities in the conditions in which people are born, live, work and age, are however driven by inequities in power, money and resources. Political, economic and resource distribution decisions made outside the health sector need to consider health as an outcome across the social distribution as opposed to a focus solely on increasing productivity. A health in all policies approach can go some way to ensure this consideration, and we present evidence that some countries are taking this approach, however given entrenched inequalities, there is some way to go. Measuring progress on the SDH globally will be key to future development of successful policies and implementation plans, enabling the identification and sharing of best practice. WHO work to align measures with the sustainable development goals will help to forward progress measurement.
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            Women’s autonomy and maternal healthcare service utilization in Ethiopia

            Fentanesh Tiruneh, Kun-Yang Chuang, Ying-Chih Chuang (2017)
            Background Most previous studies on healthcare service utilization in low-income countries have not used a multilevel study design to address the importance of community-level women’s autonomy. We assessed whether women’s autonomy, measured at both individual and community levels, is associated with maternal healthcare service utilization in Ethiopia. Methods We analyzed data from the 2005 and 2011 Ethiopia Demographic and Health Surveys (N = 6058 and 7043, respectively) for measuring women’s decision-making power and permissive gender norms associated with wife beating. We used Spearman’s correlation and the chi-squared test for bivariate analyses and constructed generalized estimating equation logistic regression models to analyze the associations between women’s autonomy indicators and maternal healthcare service utilization with control for other socioeconomic characteristics. Results Our multivariate analysis showed that women living in communities with a higher percentage of opposing attitudes toward wife beating were more likely to use all three types of maternal healthcare services in 2011 (adjusted odds ratios = 1.21, 1.23, and 1.18 for four or more antenatal care visits, health facility delivery, and postnatal care visits, respectively). In 2005, the adjusted odds ratios were 1.16 and 1.17 for four or more antenatal care visits and health facility delivery, respectively. In 2011, the percentage of women in the community with high decision-making power was positively associated with the likelihood of four or more antenatal care visits (adjusted odds ratio = 1.14). The association of individual-level autonomy on maternal healthcare service utilization was less profound after we controlled for other individual-level and community-level characteristics. Conclusions Our study shows that women’s autonomy was positively associated with maternal healthcare service utilization in Ethiopia. We suggest addressing woman empowerment in national policies and programs would be the optimal solution. Electronic supplementary material The online version of this article (10.1186/s12913-017-2670-9) contains supplementary material, which is available to authorized users.
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              Grand multiparity: is it still a risk in pregnancy?

              Andrew Mgaya, Siriel N. Massawe, Hussein L Kidanto … (2013)
              Background The association of grand multiparity and poor pregnancy outcome has not been consistent for decades. Classifying grand multiparous women as a high-risk group without clear evidence of a consistent association with adverse outcomes can lead to socioeconomic burdens to the mother, family and health systems. We compared the maternal and perinatal complications among grand multiparous and other multiparous women in Dar es Salaam in Tanzania. Methods A cross-sectional study was undertaken at Muhimbili National Hospital (MNH). A standard questionnaire enquired the following variables: demographic characteristics, antenatal profile and detected obstetric risk factors as well as maternal and neonatal risk factors. Predictors of adverse outcomes in relation to grand multiparous women were assessed at p = 0.05. Results Grand multiparas had twice the likelihood of malpresentation and a threefold higher prevalence of meconium-stained liquor and placenta previa compared with lower-parity women even when adjusted for age. Neonates delivered by grand multiparous women (12.1%) were at three-time greater risk of a low Apgar score compared with lower-parity women (5.4%) (odds ratio (OR), 2.9; 95% confidence interval (CI), 1.5–5.0). Grand multiparity and low birth weight were independently associated with a low Apgar score (OR, 2.4; 95%, CI 1.4–4.2 for GM; OR, 4.2; 95% CI, 2.3–7.8) for low birth weight. Conclusion Grand multiparity remains a risk in pregnancy and is associated with an increased prevalence of maternal and neonatal complications (malpresentation, meconium-stained liquor, placenta previa and a low Apgar score) compared with other multiparous women who delivered at Muhimbili National Hospital.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Environ Res Public Health
                Journal ID (iso-abbrev): Int J Environ Res Public Health
                Journal ID (publisher-id): ijerph
                Title: International Journal of Environmental Research and Public Health
                Publisher: MDPI
                ISSN (Print): 1661-7827
                ISSN (Electronic): 1660-4601
                Publication date (Electronic): 28 July 2020
                Publication date (Print): August 2020
                Volume: 17
                Issue: 15
                Electronic Location Identifier: 5421
                Affiliations
                [1 ]Department of Surveying and Geomatics, Midlands State University, P. Bag 9055, Gweru, Zimbabwe; nyapweren@ 123456staff.msu.ac.zw (N.N.); makangap@ 123456staff.msu.ac.zw (P.T.M.)
                [2 ]Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, Strand, London WC2R 2LS, UK; laura.a.magee@ 123456kcl.ac.uk (L.A.M.); sophie.moore@ 123456kcl.ac.uk (S.E.M.); rachel.craik@ 123456kcl.ac.uk (R.C.); PVD@ 123456kcl.ac.uk (P.v.D.)
                [3 ]Department of Obstetrics and Gynaecology and BC Children’s Hospital Research Institute, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, BC V6Z 2K8, Canada; Marianne.Vidler@ 123456cw.bc.ca
                [4 ]Medical Research Council (MRC) Unit, LSHTM Atlantic Boulevard, Fajara P. O. Box 273, Banjul, The Gambia
                [5 ]Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, Michael Uren Biomedical Engineering Hub, White City Campus, Wood Lane, London W12 0BZ, UK; b.barratt@ 123456imperial.ac.uk
                [6 ]NIHR HPRU in Environmental Exposures and Health, Imperial College London, Michael Uren Biomedical Engineering Hub, White City Campus, Wood Lane, London W12 0BZ, UK
                Author notes
                [* ]Correspondence: dubeyp@ 123456staff.msu.ac.zw ; Tel.: +263-774-920-067
                [†]

                Members are listed at the Acknowledgments.

                Author information
                https://orcid.org/0000-0002-7678-3166
                https://orcid.org/0000-0003-0305-6678
                https://orcid.org/0000-0002-1355-610X
                https://orcid.org/0000-0002-7633-8812
                https://orcid.org/0000-0003-4136-3070
                Article
                Publisher ID: ijerph-17-05421
                DOI: 10.3390/ijerph17155421
                PMC ID: 7432342
                PubMed ID: 32731379
                SO-VID: 91ba77f1-9110-4d16-82d8-4e0fdcf95c2c
                Copyright © © 2020 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 13 July 2020
                Date accepted : 22 July 2020
                Categories
                Subject: Review

                ScienceOpen disciplines: Public health
                Keywords: placental function,environment,social determinants,africa
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: placental function, environment, social determinants, africa

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