ArticlePloS one2015
Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Association between postpartum depression and postpartum hemorrhage: A systematic review and meta-analysis.Acta obstetricia et gynecologica Scandinavica · 2024Pooled it
- Tools for screening maternal mental health conditions in primary care settings in sub-Saharan Africa: systematic review.Frontiers in public health · 2024Pooled it
- Maternal multimorbidity during pregnancy and after childbirth in women in low- and middle-income countries: a systematic literature review.BMC pregnancy and childbirth · 2020Pooled it
- Impact of anemia on the six-month trend of anxiety and depression in women with threatened abortion: A case-control retrospective cohort study.Caspian journal of internal medicine · 2025Article
- Prevalence of early postpartum depression and associated risk factors among selected women in southern Malawi: a nested observational study.BMC pregnancy and childbirth · 2023Observational
- Examining maternal morbidity across a spectrum of delivery locations: An analysis of the Global Network's Maternal and Neonatal Health Registry.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023Article
- Relative risk of postpartum maternal morbidity among cesarean-delivered women: A multisite prospective cohort study in a large district, India.Journal of family medicine and primary care · 2022Article
- Screening for infectious maternal morbidity - knowledge, attitudes and perceptions among healthcare providers and managers in Malawi: a qualitative study.BMC pregnancy and childbirth · 2022Article
- Observational
- Article
- Prevalence and factors associated with antenatal depressive symptoms among women enrolled in Option B+ antenatal HIV care in Malawi: a cross-sectional analysis.Journal of mental health (Abingdon, England) · 2019Article
- Article
- A framework for healthcare interventions to address maternal morbidity.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2018Review
- Burden of physical, psychological and social ill-health during and after pregnancy among women in India, Pakistan, Kenya and Malawi.BMJ global health · 2018Article
- Antenatal depressive symptoms and perinatal complications: a prospective study in rural Ethiopia.BMC psychiatry · 2017Article
- Expanding the scope beyond mortality: burden and missed opportunities in maternal morbidity in Indonesia.Global health action · 2017Article
- Pregnancy Burden: An Integrative Review and Dimensional Analysis of Pregnancy's Hidden Challenges.Journal of midwifery & women's healthReview
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundFor more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective) and psychological morbidities in two different low-income countries.
methodsCross sectional study with assessment of morbidity in early pregnancy (34%), late pregnancy (35%) and the postnatal period (31%) among 3459 women from two rural communities in Pakistan (1727) and Malawi (1732). Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity.
resultsOne in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective). Both infective (Pakistan) and non-infective morbidity (Pakistan and Malawi) was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon (<10%). There were marked differences in psychological morbidity: 26.9% of women in Pakistan 2.6% in Malawi had an Edinburgh Postnatal Depression Score (EPDS) > 9. Complications during a previous pregnancy, infective morbidity (p <0.001), intra or postpartum haemorrhage (p <0.02) were associated with psychological morbidity in both settings.
conclusionsOur findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust assessment of non-severe maternal morbidity.
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