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Health in pregnancy and post-birth: contribution to improved child outcomes

Ron Gray (Ron Gray is a Senior Clinical Research Fellow, based at National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.)
Debra Bick (Debra Bick is a Professor of Evidence Based Midwifery Practice and Yan-Shing Chang is a Research Associate, both are based at Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK.)
Yan-Shing Chang (Debra Bick is a Professor of Evidence Based Midwifery Practice and Yan-Shing Chang is a Research Associate, both are based at Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK.)

Journal of Children's Services

ISSN: 1746-6660

Article publication date: 10 June 2014

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Abstract

Purpose

The purpose of this paper is to describe the major factors affecting health during pregnancy, birth and the postnatal period and outline the evidence for interventions to improve outcomes in women and their children.

Design/methodology/approach

Selective review of the literature. A number of electronic bibliographic databases were searched, including the Cochrane Database of Systematic Reviews, PubMed and PsycINFO, for relevant studies published since 1990. Papers were restricted to those published in English which presented data from studies conducted in high-income countries, with priority given to systematic reviews, randomised controlled trials and other quantitative studies which present a higher level of evidence.

Findings

Many factors may affect maternal and infant health during and after pregnancy. Potentially modifiable factors with an evidence base to support intervention include improving diet, and the avoidance of smoking, alcohol and illicit drugs. Good clinical management of underlying illness is also important, along with attempts to engage women in improving health prior to conception and postnatally rather than once pregnancy is established.

Research limitations/implications

The evidence base for interventions on some potentially modifiable risk factors is incomplete. There is good evidence of benefit from some health behaviours such as smoking cessation and uptake of breastfeeding and accumulating evidence of the benefit of some models of maternity care.

Practical implications

Good maternal health during and after pregnancy plays a key role in giving the child a better start in life. Improved health behaviours are vital but often these are heavily dependent on social context and hence working to tackle social inequality and provide maternity care tailored to individual need is likely to be just as important as trying to directly alter behaviour.

Originality/value

Pregnancy and the postnatal period present an opportunity to improve maternal health and have a positive effect on future child health. Greater investment is required in this antenatal period of life.

Keywords

Citation

Gray, R., Bick, D. and Chang, Y.-S. (2014), "Health in pregnancy and post-birth: contribution to improved child outcomes", Journal of Children's Services, Vol. 9 No. 2, pp. 109-127. https://doi.org/10.1108/JCS-03-2014-0020

Publisher

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Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited